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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.
Chinese Medical Journal
|January 13, 2001
Summary
Renal bone disease affects all uremic patients, with high-turnover disease being most common. Bone biopsy is the best diagnostic method, though bone scans offer an alternative.
Area of Science:
- Nephrology
- Endocrinology
- Pathology
Background:
- Renal bone disease is a common complication in uremic patients.
- Pathologic changes in bone are consistently observed in individuals with chronic kidney disease.
Purpose of the Study:
- To determine the incidence, pathology, mechanisms, and diagnostic approaches for renal bone disease.
- To evaluate the utility of bone biopsy and bone scintigraphy in diagnosing renal bone disease.
Main Methods:
- Measured serum levels of carboxyterminal parathyroid hormone (C-PTH), 1,25(OH)2D3, calcium, phosphate, and aluminum.
- Performed bone biopsy and 99m technetium methylene diphosphonate (99mTC-MDP) bone scans on 51 uremic patients.
Main Results:
- All patients exhibited varying degrees of bone pathology.
- High-turnover bone disease was observed in 50.9%, low-turnover in 7.8%, and mixed-type in 41.8%.
- Elevated C-PTH correlated with high-turnover disease; decreased 1,25(OH)2D3 was noted in low-turnover disease. Bone scans showed high diagnostic accuracy.
Conclusions:
- Bone pathology examination is the most definitive diagnostic method for renal bone disease.
- 99mTC-MDP bone scans provide valuable diagnostic information when bone biopsy is not feasible.