The effects of extreme low frequency pulsed electromagnetic field on bone mineral density and incidence of fractures in patients with end –stage renal disease on dialysis – three year follow up study

Aleksandra Rakočević-Hrnjak; Miljanka Vuksanović; Nada Dimković; Aleksandar Djurović; Nataša Petronijević; Milan Petronijević

doi:10.2298/VSP160617212R

Aleksandra Rakočević-Hrnjak Centre of Physical Medicine and Rehabilitation, University Medical Centre Zvezdara, Belgrade, Serbia
Miljanka Vuksanović Clinic of Internal Medicine, University Medical Centre Zvezdara, Belgrade, Serbia
Nada Dimković Clinic of Internal Medicine, University Medical Centre Zvezdara, Belgrade, Serbia
Aleksandar Djurović Clinic for Physical Medicine and Rehabilitation, Military Medical Academy, Medical Faculty, University of Defence, Belgrade, Serbia
Nataša Petronijević Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Serbia
Milan Petronijević Clinic for Rheumatology and Clinical Immunology, Military Medical Academy, Medical Faculty, University of Defence, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP160617212R

Keywords: kidney failure, chronic;, renal dialysis;, electromagnetic fields;, bone density;, fractures, bones;, incidence;, treatment outcome

Abstract

Background/Aim. A variety of physical therapy options has been developed for the treatment of musculoskeletal disorders including those characterized with low bone mineral density (BMD). Extreme low frequency pulsed electromagnetic field (ELF-PEMF) can accelerate bone formation. Patients with end stage of renal disease (ESRD) are predisposed to high incidence of fractures due to bone disorder with multifactorial pathogenesis. Vitamin D, calcium supplements, antiresorptive and anabolic drugs in those patients have changed pharmacodynamics and pharmacokinetics and have minimal or limited effects. The aim of this study was to assess the effectiveness of long-term ELF-PEMF therapy applied in concordance with physical exercise on bone mass, incidence of new bone fractures and parathyroid hormone concentrations in ESRD patients on dialysis. Methods. In this 3-year prospective clinical trial, 151 patients with ESRD on dialysis program were subjected to treatment with ELF-PEMF (18 Hz, 2 mT) applied during 40 min after 10 consecutive dialysis procedures, 4 times through one year (120 treatments in total during three years) together with kinesitherapy (study group) or only with kinesitherapy (control group) on the voluntary basis. Results. Total of 124 patients have completed the study. In the study group (n = 54), regardless of sex, significant improvements of BMD, T-score and Z-score on both lumbar spine and femoral neck were achieved after 3-year treatment with ELF-PEMF. In the control group (n = 70), significant decreases of BMD, T-score and Z-score as well as the higher incidence of new bone fractures were recorded. Conclusion. ELF-PEMF could be a convenient and safe non-pharmacological therapeutic strategy for fracture prevention in nephrology practices.

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