Abstract

Background

Increased vascular stiffness is associated with low bone mineral density (BMD) in the general population, and both are risk factors for mortality. We wished to determine whether vascular stiffness is associated with BMD in peritoneal dialysis (PD) patients.

Methods

We measured vascular stiffness by aortic pulse wave velocity (aPWV), BMD by dual electron absorptiometry (DXA) scanning, and body composition using bioimpedance.

Results

We reviewed DXA scans in 125 PD patients, 56.8% male, mean age 64.4 ± 15.3 years, mean aPWV, 10.2 ± 2.6 m/s. We divided patients by aPWV (< 10 and > 10 m/s), and there were no statistical differences in patient demographics, body composition, PD adequacy, peritoneal and urinary calcium losses. On univariate analysis aPWV was negatively associated with total body T score (r = − 0.20, p = 0.037). On multivariable logistic regression patients with higher aPWV were prescribed fewer non-calcium containing phosphate binders, odds ratio (OR) 0.83, 95% confidence interval (CI) 0.70–0.99, p = 0.039, more had lower 25 hydroxy-vitamin D₃ concentrations < 50 ng/L (OR 0.34, CI 0.12–0.93, p = 0.035, and lower femoral BMD OR 0.03 (CI 0–0.3.4), p = 0.029, but there was no association with total or lumbar spine BMD.

Conclusion

Our study reinforces the hypothesis of a link between bone disease and vascular disease in dialysis patients. As patients with higher aPWV were prescribed fewer non-calcium containing phosphate binders and fewer had higher 25 hydroxy-vitamin D₃ concentrations, then this raises the possibility that differences in clinical practice and drug prescribing may help to reduce vascular stiffness, which will require testing in future trials.