Assessment of Bone Mineral Density (BMD) In Children with Advanced CKD (Stage 3 To 5): Experience from Tertiary Care Center, Dhaka, Bangladesh

Abstract

Background: Chronic kidney disease (CKD) has impact on bone development, remodeling, and modeling. Assessment of bone health is a key element in the management of CKD. Objective: To assess bone mineral density (BMD) in children with advanced CKD (stage 3 to 5). Methodology: This cross-sectional study was carried out in the department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2022 to March 2023. A total 45 children with advanced CKD (stage 3 to 5) were included in the study. Serum calcium, phosphate and iPTH were measured and bone mineral density of lumber spine and femoral neck was measured by using dual energy absorptiometry (DEXA). Results: Total 45 patients were studied. Serum biochemical marker (calcium, phosphate, iPTH and alkaline phosphatase) showed significant changes in CKD stage 5 and 5D (p=0.03, p=0.04, p= 0.001 and p= 0.014 respectively). Eleven patients (24.44%) had skeletal deformities; most were from stage 5D (p=0.01). No significant changes were found in bone mineral density Z score among different stages of CKD and dialysis group. Conclusion: Bone mineral density did not differ significantly in different stages of CKD in children.