Comparison of CT Scan and Bone Mineral Densitometry for Diagnosing Osteoporosis and Osteopenia in Patients with Chronic Kidney Disease

Abstract

Background: Osteoporosis is characterized by decreased bone strength and a higher fracture risk. Objectives: This study aimed to compare computed tomography (CT) scans and bone densitometry for diagnosing osteoporosis and osteopenia. Methods: A descriptive-analytical cross-sectional study was conducted on 322 kidney failure patients admitted to Baqiyatallah Hospital in 2021. Descriptive statistics (mean, standard deviation, frequency, minimum, and maximum) and logistic regression analysis were utilized. Data were collected and entered into SPSS software version 24, and descriptive and inferential statistics were applied. A significance level of 5% was established. Results: The data demonstrated a significant linear relationship between CT scan-based bone density of the L1 vertebra and spine bone density measurement (Pearson’s R = 0.58, P ≤ 0.001). Although a significant linear relationship was observed between L1 bone density via CT scan and femur bone density measurement (Pearson’s R = 0.44, P ≤ 0.001), this correlation was weaker than that of spine bone density measurements. Spearman’s rank correlation test revealed a marginally significant linear relationship between L1 bone density using CT scan and forearm bone density measurement (ρ = 0.20, P = 0.05). After categorizing the data into normal, osteopenia, and osteoporosis groups, Spearman’s test indicated a significant linear relationship between L1 bone density and femur bone density (ρ = 0.48, P ≤ 0.001). Similarly, when the data were grouped into these categories, a marginally significant linear relationship was observed between L1 bone density by CT scan and forearm bone density (Spearman’s ρ = 0.20, P = 0.05). Conclusions: The findings highlight a significant relationship between CT scan-based L1 bone density and bone density measurements of the spine, femur, and forearm, with the strongest correlation observed in spine measurements. Therefore, utilizing L1 bone density assessment via CT scans — a non-invasive method often performed for other clinical purposes — can serve as an opportunistic tool for osteoporosis and osteopenia screening. This approach not only reduces costs but also facilitates early detection of osteoporosis.