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Relation between bone mineral density and oxidative stress in Egyptian patients with chronic kidney disease: a cross sectional study

Akab SM, Abozeid HE, Elazab SA, Elazab SAF, ElBazzar N, Youness ER, Shahba MA, Orban HA et al.

BMC nephrology, 2025

150 participants

Abstract

Background: Chronic kidney disease (CKD) patients are prone to osteoporosis (OP) and they had significant oxidative stress. The relationship between oxidative stress (OS) and bone mineral density (BMD) in CKD is not entirely clear. The investigation of this relation is of pronounced importance in decreasing the occurrence of osteoporosis among CKD cases.

Objectives: To evaluate the association between BMD and OS in CKD patients.

Methods: We performed a case-control study, including 150 adults with CKD (stage 1-5 according to Kidney Disease Improving Global Outcomes (KDIGO) classification, 2024) and 150 healthy controls. CKD patients were further subdivided to 3 subgroups based on estimated glomerular filtration rate: stage 1-2, stage 3-4 and stage 5. BMD at the lumbar spine (LS), femur neck (FN), and distal radius (DR) were measured using DEXA. Vitamin D and OS biomarkers including; 8-Hydroxy-2'-deoxyguanosine (8-OHdG) and Malondialdehyde (MDA) were measured. Paraoxonase1 (PON1) as a biomarker of antioxidant response was assessed. Statistical analysis was performed using the appropriate tests.

Results: The CKD cases showed lower BMD T-Scores than healthy controls. Moreover, LS, DR, and FN BMDs were significantly different between CKD stages. Post hoc analyses showed higher LS, DR, and FN T-Scores in Stage I-II vs. Stage III-IV and Stage V. However, no significant differences were noted between stage III-IV and stage V for all sites. Significant increase in OS biomarkers…

How strong is the evidence?

Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 150 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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