Bone mineralization disorder in patients on chronic hemodialysis and the effect on the occurrence of muscle hypotrophy

Elvedin Osmanovic 1, *, Amir Jagodic 2, Irma Jagodić 3 and Mersiha Cerkezovic 1

1 Haemodialysis center, medical health center, Bosnia and Herzegovina.
2 Center for physical medicine and rehabilitation, medical health center, Bosnia and Herzegovina.
3 Emergency medical service, medical health center, Bosnia and Herzegovina.
 
Magna Scientia Advanced Research and Reviews, 2025, 14(01), 039-049
Article DOI: 10.30574/msarr.2025.14.1.0075
Publication history: 
Received on 28 April 2025; revised on 05 June 2025; accepted on 07 June 2025
 
Abstract: 
Bone mineralization disorders in patients undercoating chronic hemodialysis commonly arise due to secondary hyperparathyroidism, a condition characterized by disrupted parathyroid hormone (PTH) regulation. PTH increases bone resorption and affects calcium and phosphorus levels in the body, enhances calcium reabsorption in the kidneys and intestines, and elevates phosphorus excretion through the kidneys. Chronic kidney disease leads to dysregulation of PTH secretion, resulting in secondary hyperparathyroidism.
The aims of this study were to assess muscle weakness in osteoporotic extremities, investigate the role of rehabilitation exercises in hemodialysis patients to prevent lower extremity muscle atrophy, and highlight the significance of calcimimetics and vitamin D analogs.
Study results indicate
  • High correlation between bone mineralization disorders and P and Ca disorders in patients on a chronic hemodialysis program 
  • High correlation between mineralization disorders and muscular hypotrophy.
  • Moderate positive correlations among P values and urate, T and Z scores, pulse rate, respiratory rate, and systolic blood pressure
In our study, initial physical functioning was poor, but after physiotherapy, almost all patients in both groups reported improvement, evident from analysis of the 6-minute walk test (6MWT) and manual muscle test (MMT). There was an increase in bone mineral density, strengthening of leg and back muscles, and improvement in patient mobility and stability.
It is crucial to emphasize that complete recovery is not achievable without rehabilitation. Post-fracture rehabilitation plays a significant role in patient recovery and returns to daily activities. Physical medicine, including electrotherapy, cryotherapy, and kinesiotherapy, contributes to faster recovery. Therefore, the importance of physical therapy, both post-surgical and non-surgical fracture treatments, cannot be overstated.
 
Keywords: 
Bone Mineralization Disorder; Rehabilitation; Dialysis, Muscular hypotrophy
 
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