Bone turnover correlates with bone quantity but not bone microarchitecture in chronic hemodialysis

Introduction In chronic hemodialysis, high-turnover bone disease was associated with decreased bone mineral density (BMD), poor bone quality (chemical and structural), and increased fracture risk. Our aim was to correlate bone turnover markers (BTMs) with bone microarchitecture measured by trabecular bone score (TBS) before and after correction for BMD. Materials and methods We measured lumbar spine (LS), femoral neck, and 1/3 radius BMD and LS TBS by dual X-ray absorptiometry in 81 patients on permanent hemodialysis. Bone turnover was assessed using serum parathyroid hormone, osteocalcin, C-terminal crosslaps of type 1 collagen, procollagen 1 N-terminal propeptide (P1NP), and alkaline phosphatase (ALP). No patient had any partial or total parathyroidectomy and no previous or current treatment with anti-osteoporotic drugs. Results All BTMs correlated significantly with each other. Univariate regressions showed significant negative correlations between BTMs and BMD (best r = − 0.53, between P1NP and 1/3 radius Z -score) or BTMs and TBS (best r = − 0.27, p