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J Nephrol. 2000 Nov-Dec;13(6):437-43.

Correlation of bone mineral density with the histological findings of renal osteodystrophy in patients on hemodialysis.

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  • 1Evangelismos Hospital, Athens, Greece. gerakisa@otenet.gr

Abstract

AIMS:

To examine the distribution of bone mineral density (BMD) in different histological groups of renal osteodystrophy.

PATIENTS:

We prospectively studied 62 patients, 41 men and 21 women, aged 57+/-11.5 years, who had been on hemodialysis for 60+/-55 months. The women had been amenorrheic for 13+/-4 years and 7 patients (11%) had a positive fracture history.

METHODS:

A bone biopsy was taken after tetracycline labelling and BMD of the lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry (DEXA); serum intact parathyroid hormone (iPTH), bone Gla protein (BGP), phosphorus, calcium and alkaline phosphatase (ALP) were also determined.

RESULTS:

Histologically, 40 patients showed secondary hyperparathyroidism (sHPT), 6 mixed bone disease, 14 adynamic bone disease (A) and 2 osteomalacia. BMD of the lumbar spine was decreased in 43 patients (69%) and in 9 (14.5%) it was lower than -2 Z score units. BMD of the femoral neck was low in 55 patients (89%) and in 22 (35.5%) it was lower than -2 Z scores. BMD was lower in patients with sHPT than in those with adynamic bone disease (p<0.05) in which it was close to normal. BMD in both these sites correlated inversely with the biochemical markers (serum iPTH, BGP and ALP) and the histomorphometric indices of bone turnover.

CONCLUSIONS:

Osteopenia is frequent in patients on hemodialysis, especially those with biochemical and histological findings of sHPT.

PMID:
11132760
[PubMed - indexed for MEDLINE]
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