Advanced stages of chronic kidney disease (CKD) are associated with abnormalities in bone and mineral health of the patient. They may manifest as decreased bone mineral density, abnormalities in bone volume, calcification of vascular and/or soft tissues. Low bone mineral density (BMD) as measured by dual-energy X-ray absorptiometry, predicts the risk of fragility fracture. Skeletal fractures are important cause of CKD-related morbidity.

Despite of high prevalence of decreased bone mineral density in CKD, diagnosis and role of bone mineral density remain understudied in India. Further, the studies are needed to determine the factors associated with low BMD.

In this study, we will measure BMD by DEXA scan and determine the prevalence of low BMD in advanced CKD in Indian population. With the use of statistical tests, we will observe relationship between low BMD and Stage of CKD, biochemical markers, age, gender and BMI and various other determinants of low BMD.

This cross-sectional observational study will be carried out over period of 18 months and will include adult patients with advanced CKD, admitted in wards or seen in outpatient of KEM Hospital, Pune. Post renal transplant patients, pregnant, patients with previous spine surgery and those on osteoporosis therapy will be excluded.

We expect to determine prevalence of low BMD in advanced CKD in Indian population and establish relationship between low BMD with stage of CKD, biochemical markers and demographical parameters which will help in early suspicion and diagnosis of CKD-MBD and effect of modifications in determinants on clinical outcome.