Radial Bone Mineral Density in Hemodialysis Patients with Adynamic Bone Disease

2003 ◽  
Vol 26 (3) ◽  
pp. 200-204 ◽  
Author(s):  
A. Nakashima ◽  
N. Yorioka ◽  
S. Doi ◽  
C. Ueda ◽  
K. Usui ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Disease ◽  
Hemodialysis Patients ◽  
Mineral Density ◽  
Intact Pth ◽  
Adynamic Bone Disease ◽  
Normal Bone ◽  
Phosphate Product ◽  
Adynamic Bone

Adynamic bone disease (ABD) has attracted attention as the most frequent type of renal osteodystrophy, but there are few reports about the bone mineral density (BMD) in ABD patients. This study investigated the BMD in hemodialysis patients with ABD and with relatively normal bone turnover. We measured the BMD of the distal one-third of the radius by dual-energy X-ray adsorptiometry. In the ABD group (intact PTH<65pg/ml, intact osteocalcin<30ng/ml), there were 19 men and 17 women with a mean age of 56.4±12.0 years. In the relatively normal bone turnover group (intact PTH: 120-250pg/ml), there were 24 men and 16 women with a mean age of 57.1±14.7 years. Although there were no significant differences between the two groups with respect to age, gender, and duration of hemodialysis, a significant increase of the BMD and the calcium x phosphate product was observed in the ABD group (radial BMD: 0.648±0.137 g/cm2 versus 0.572±0.132 g/cm2, calcium x phosphate product: 57.53±14.92 mg2/dl2 versus 49.76±12.13 mg2/dl2). These findings suggest that an increase in radial BMD may not be a useful marker of the improvement in bone lesions in ABD patients.

scholarly journals SO07118F-SODIUM FLUORIDE POSITRON EMISSION TOMOGRAPHY AND BONE HISTOMORPHOMETRY - COMPARISON BETWEEN ONLY BONE TURNOVER -BASED AND EXPERT EVALUATION -BASED CLASSIFICATION OF RENAL OSTEODYSTROPHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Louise Caroline Aaltonen ◽  
Niina Koivuviita ◽  
Marko Seppänen ◽  
Inari Burton ◽  
Heikki Kröger ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Renal Osteodystrophy ◽  
Bone Disease ◽  
Bone Biopsy ◽  
Formation Rate ◽  
Adynamic Bone Disease ◽  
High Turnover ◽  
Bone Formation Rate ◽  
Adynamic Bone

Abstract Background and Aims The diagnosis and the differentiation of renal osteodystrophy (ROD) are challenging. Bone biopsy is the golden standard, but it is invasive and not available in every center. Bone turnover rate is defined by bone formation rate and/or activation frequency. Adynamic bone disease is defined as low turnover bone with reduced osteoblast- and osteoclast activities. Hyperparahyreoid bone disease or osteitis fibrosa is defined as high turnover bone with osteoclast- and osteoblast activities and fibrosis. 18F- Sodium Fluoride positron emission tomography (18F-NaF PET) is a noninvasive imaging technique that allows assessment of regional bone turnover. The aim was to assess how well bone turnover –based classification of ROD correlates with the classification determined by an expert histomorphometrist (HK), and how these correlate with 18F-NaF PET analysis Method A total of 24 dialysis patients underwent a 18F-NaF PET scan. Fluoride activity was measured at the anterior iliac crest and in the lumbar region. An iliac crest bone biopsy was obtained within 4 weeks from the PET-scan. The diagnosis of bone histomorphometry was determined based on turnover-mineralization-volume (TMV) classification. Firstly, bone turnover was assessed using bone formation rate and activation frequency. Secondly, also other histomorphometric parameters (eg. osteoid volume, osteoid surface, resorption surface, mineralized surface, osteoblast and osteoclast surfaces and peritrabecular fibrosis) were also taking into account for classification of ROD by a histomorphometrist. Results Based on bone turnover parameters only, 12% of the patients had high turnover and 64% low turnover. When the diagnosis of renal osteodystrophy was made by a histomorphometrist, 40% had hyperparathyreoid bone/osteitis fibrosa and 24% adynamic bone disease or ostemalasia. 18F-NaF PET´s sensitivity to recognize hyperparathyreoid bone disease was 80% end specificity 100% (cut-of value 0.055).18F-NaF PET´s sensitivity to recognize adynamic bone disease was 100% and specificity 61% (cut-of value of fluoride-activity 0.038) Conclusion 18F-NaF PET works well as a diagnostic tool, when the diagnosis of ROD is based on the histopathological evaluation. It remains unknown how variations in normal bone turnover rate can be detected in CKD patients by 18F-NaF PET and if treatment decisions of ROD can be made only based on bone turnover.

Relationship between bone mineral density and biochemical markers of bone turnover in hemodialysis patients

2007 ◽  
Vol 24 (5) ◽  
pp. 987-995 ◽  
Author(s):  
Dede Sit ◽  
Ali Kemal Kadiroglu ◽  
Hasan Kayabasi ◽  
A. Engin Atay ◽  
Zulfukar Yilmaz ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Biochemical Markers ◽  
Hemodialysis Patients ◽  
Mineral Density ◽  
Markers Of Bone Turnover

Variant of Adynamic Bone Disease in Hemodialysis Patients: Fact or Fiction?

2006 ◽  
Vol 48 (3) ◽  
pp. 430-436 ◽  
Author(s):  
Lillian A. Rocha ◽  
Andrea Higa ◽  
Fellype C. Barreto ◽  
Luciene M. dos Reis ◽  
Vanda Jorgetti ◽  
...  
Keyword(s):  
Bone Disease ◽  
Hemodialysis Patients ◽  
Adynamic Bone Disease ◽  
Adynamic Bone

scholarly journals Underlying Mechanisms Between Diabetes Mellitus and Osteoporosis

2018 ◽  
Vol 14 (2) ◽  
pp. 65
Author(s):  
Oscar Rosero Olarte ◽  
Mauricio Alvarez Andrade ◽  
◽  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Disease ◽  
Diagnostic Methods ◽  
Mineral Density ◽  
X Ray ◽  
Increased Risk ◽  
Underlying Mechanisms

Several studies have linked diabetes mellitus with an increased risk of bone fractures. Patients with type 1 diabetes have lower bone mineral density and patients with type 2 diabetes have an increased risk of fracture despite normal or high bone mineral density, measured by dual energy x-ray absorptiometry. Different mechanisms have been proposed in the pathophysiology of bone disease in diabetic patients. The mechanisms involved include microvasculature changes, advanced glycation end products accumulation, and altered osteoblast–osteoclast function with increased sclerostin, decreased insulin-like growth factor 1 (IGF1), decreased osteocalcin, and other molecular alterations, leading to a decrease in bone turnover and altered bone quality. Other factors, such as increased risk of falls related to diabetic neuropathy and diabetic retinopathy have also been proposed. Different diagnostic methods have been described for the study of bone disease in patients with diabetes, due to the lack of correlation between bone mineral density measured by dual x-ray absorptiometry and the fracture risk in this group of patients. These methods include the evaluation of bone turnover markers, the FRAX score, the trabecular bone score, and the evaluation of microarchitecture with high-resolution peripheral quantitative tomography. This editorial provides a short overview of the underlying mechanisms between diabetes mellitus and osteoporosis, and the diagnostic methods used to evaluate these patients.

Vitamin D3 Withdrawal in Hemodialysis Patients with Adynamic Bone Disease

Nephron ◽  
1998 ◽  
Vol 80 (1) ◽  
pp. 89-89 ◽  
Author(s):  
Mitsuhiro Kondo ◽  
Toru Hyodo ◽  
Tadasu Sakai
Keyword(s):  
Vitamin D ◽  
Bone Disease ◽  
Hemodialysis Patients ◽  
Adynamic Bone Disease ◽  
Adynamic Bone

scholarly journals Bone Histomorphometry and 18F-Sodium Fluoride Positron Emission Tomography Imaging: Comparison Between only Bone Turnover-based and Unified TMV-based Classification of Renal Osteodystrophy

2021 ◽  
Author(s):  
Louise Aaltonen ◽  
Niina Koivuviita ◽  
Marko Seppänen ◽  
Inari S. Burton ◽  
Heikki Kröger ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Bone Turnover ◽  
Bone Disease ◽  
Bone Biopsy ◽  
Emission Tomography ◽  
Adynamic Bone Disease ◽  
High Turnover ◽  
Positron Emission ◽  
Adynamic Bone

AbstractBone biopsy is the gold standard for characterization of renal osteodystrophy (ROD). However, the classification of the subtypes of ROD based on histomorphometric parameters is not unambiguous and the range of normal values for turnover differ in different publications. 18F-Sodium Fluoride positron emission tomography (18F-NaF PET) is a dynamic imaging technique that measures turnover. 18F-NaF PET has previously been shown to correlate with histomorphometric parameters. In this cross-sectional study, 26 patients on dialysis underwent a 18F-NaF PET and a bone biopsy. Bone turnover-based classification was assessed using Malluche’s historical reference values for normal bone turnover. In unified turnover-mineralization-volume (TMV)-based classification, the whole histopathological picture was evaluated and the range for normal turnover was set accordingly. Fluoride activity was measured in the lumbar spine (L1–L4) and at the anterior iliac crest. On the basis of turnover-based classification of ROD, 12% had high turnover and 61% had low turnover bone disease. On the basis of unified TMV-based classification of ROD, 42% had high turnover/hyperparathyroid bone disease and 23% had low turnover/adynamic bone disease. When using unified TMV-based classification of ROD, 18F-NaF PET had an AUC of 0.86 to discriminate hyperparathyroid bone disease from other types of ROD and an AUC of 0.87, for discriminating adynamic bone disease. There was a disproportion between turnover-based classification and unified TMV-based classification. More research is needed to establish normal range of bone turnover in patients with CKD and to establish the role of PET imaging in ROD.

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