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Pathologic changes, mechanisms and diagnosis in renal bone disease
1Department of Nephrology, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Objective:
To investigate the incidence rate, pathologic changes, mechanisms and diagnostic methods in renal bone disease.
Methods:
The blood levels of carboxyterminal parpthyriod hormone (C-PTH), 1,25(OH)2D3, calcium and phosphate, aluminum in serum and bone tissue were measured. The bone biopsy and bone scan with 99m technetium methylene diphosphonate (99mTC-MDP) were performed in 51 uremic patients.
Results:
One hundred per cent of the patients had varying degree of pathologic changes in bone, in which 50.9% of the patients presented high-turnover bone disease, 7.8% of the patients presented low-turnover bone disease and 41.8% of the patients had mixed-type bone disease. The levels of serum C-PTH were predominently high in high-turnover bone disease while the levels of serum 1,25(OH)2D3 were significantly decreased in low-turnover bone disease. There was a high positive rate for the diagnosis of renal bone disease by bone scan with 99mTC-MDP.
Conclusions:
The examination of bone pathology is the most valuable method for the diagnosis of renal bone disease. Bone scan with 99mTC-MDP has reference value when clinical conditions do not allow to make bone biopsy.