Long-term observation on renal-osteodystrophy-related parameters in dialysis patients

Among chronic haemodialysis patients, renal osteodystrophy is one of the most serious long-term complications which should be solved for substantially improving the quality of their lives. However, due to its multifactorial mechanism and the difficulty of its diagnosis, a final protocol to ameliorate and/or prevent renal osteodystrophy is difficult to establish. To discover any clues to a solution, we performed long-term observations on renal osteodystrophy-related parameters in chronic haemodialysis patients over 9 years, starting in 1980, focusing mainly on X-ray photodensitometry. Taking into consideration changes of treatments prescribed and/or tried during this period, changes of renal osteodystrophy-related parameters including metacarpal index, bone mineral content, and bone index were periodically monitored. While bone mineral content and bone index deteriorated for patients who were commenced on haemodialysis in 1980, during the consecutive 4 years, bone mineral content was significantly improved, with maintained bone index during the last 4 years for patients started on haemodialysis in 1985. Thirty-one male and thirteen female patients, monitored throughout the 9 years, showed a significant increase in bone mineral content during the past 4 years. The combined effects of current modality such as bicarbonate dialysate, active vitamin D3 and removal of accumulated aluminium, are suggested explanations.