Long-term heparin use may lead to reduced bone mineral density
Long-term use of unfractionated heparin may be associated with the loss of lumbar spine bone mineral density in patients undergoing maintenance hemodialysis treatment, according to a published study.
“In patients undergoing maintenance hemodialysis (MHD), chronic kidney disease mineral and bone disorder makes the relationship between heparin and osteoporosis more complex,” Shuo Yang, PhD, from the department of nephrology at Peking University People’s Hospital, and colleagues wrote. “To date, few studies have focused on the effects of long-term use of unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) on bone mineral density (BMD) change in patients undergoing MHD.”
In a single-center, prospective, prevalent cohort study, 72 patients on maintenance hemodialysis were evaluated for associations between use of UFH or LMWH and changes in lumbar spine and femoral neck BMD between 2011 and 2017. Patients received DEXA to evaluate BMD, T-score and Z-score of the lumbar spine and of the left proximal femur at baseline and 2-year follow-up.
Of the evaluated patients at follow-up, 13.64% displayed bone loss progression while 86.36% showed no progression. Lumbar spine results yielded mean changes in BMD (UFH group: 0 vs. LMWH group: 0.04), T-score (UFH group: 0 vs. LMWH group: 0.35) and Z-score (UFH group: 0.10 vs. LMWH group: 0.45). The proximal femur showed no significant change in BMD.
“Long-term use of heparin is associated with bone loss, osteoporosis and fracture in nondialysis patients. In this study, we found that UFH might be related to the loss of lumbar spine BMD in patients undergoing MHD,” Yang and colleagues concluded. “Further studies with larger sample sizes and longer follow-up periods are needed to conrm the effect of heparin substances on BMD in patients undergoing MHD.”