한국 노인에게서 정상에서 중등도로 감소된 신장기능과 골강도 간의 연관성

The Relationship between Normal to Moderately Decreased Renal Function and Bone Strength in Korean Elderly Population

Background: There are few studies regarding whether mildly decreased renal function is related to bone health and the prevalence of osteoporotic fracture, especially in healthy older people in Korea. This study was aimed to investigate the association of mild renal dysfunction and bone health in Korean aged 65 years old or greater. Methods: A total of 1,064 participants with normal or mild to moderate renal dysfunction from Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population were included. Subjects were categorized into two groups according to estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease equation: stage 1-2 (eGFR≥60 mL/min/1.73 mE) and stage 3 (30≤eGFR＜60 mL/min/1.73 mE) groups. Bone strength was measured by bone stiffness index (BSI) using the calcaneal quantitative ultrasound. Results: There was significant negative relationship between eGFR and BSI in female subjects with chronic kidney disease (CKD) stage 1-2 groups, whereas eGFR was not associated with BSI in either male or female subjects with CKD stage 3. The association between the prevalence of osteoporotic fracture and CKD stage was not significant between the two groups of either male or female subjects. Conclusion: Mildly decreased renal function does not relate to bone strength in most of healthy older people in Korea. Longitudinal studies would be necessary to clarify whether mild renal dysfunction can affect bone health in Korean older people.