Dual-Energy X-ray Absorptiometry and Bone Densitometry in CKD Children on Regular Haemodialysis

Ramadan, Seham Mohammed Ibrahim; Amin, Ezzat K.; Hassan, Esraa Attia Ebrahim; Amin, Mohamed Ibrahim; Abdel Hady, Eman Mohammed

doi:10.21608/zumj.2025.404927.4057

Dual-Energy X-ray Absorptiometry and Bone Densitometry in CKD Children on Regular Haemodialysis

Document Type : Original Article

Authors

¹ Lecturer of Pediatrics, Faculty of Medicine, Zagazig University

² Professor of Pediatrics, Faculty of Medicine, Zagazig University

³ MBBCH, Faculty of Medicine, Zagazig University

⁴ Professor of Radiodiagnosis, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.404927.4057

Abstract

Background: Children who had chronic kidney disease (CKD) could be usually at high risk of disturbances in bone mineral metabolism, that could impair growth and increase fracture risk. Dual-energy X-ray absorptiometry (DEXA) could be considered as the gold standard evaluation tool for bone mineral density (BMD) among these patients. This study aimed to assess bone mineral density and body composition in children who had CKD and undergoing hemodialysis using DEXA.

Methods: This cross-sectional study involved 39 children with CKD on regular hemodialysis at Zagazig University Children’s Hospital. All participants underwent comprehensive clinical assessment, laboratory investigations for mineral metabolism (calcium, phosphorus, parathyroid hormone (PTH), vitamin D, and DEXA scans of the lumbar spine and whole body.

Results: The mean lumbar spine BMD was 0.63 ± 0.1 g/cm², with a median Z-score of +0.6; 43.6% had osteopenia (Z ≤ –1) and 7.7% had osteoporosis (Z ≤ –2.5). Higher PTH and phosphorus were significantly associated with lower BMD (p < 0.01), while higher calcium and vitamin D were associated with greater BMD (p < 0.05). Older age and longer dialysis duration correlated with higher BMD (p < 0.05).

Conclusion: Metabolic factors, especially serum calcium, phosphorus, vitamin D, and PTH, were the strongest determinants of BMD in pediatric dialysis patients, outweighing demographic factors or dialysis duration. Regular DEXA screening and early management of mineral disturbances may help reduce fracture risk and improve bone health in this vulnerable group.

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