Continuous ambulatory peritoneal dialysis and bone

We studied the effects of continuous ambulatory peritoneal dialysis (CAPD) on the histological manifestations of uremic bone disease. Twelve patients underwent bone biopsy immediately prior to and after one year of such treatment. Those with larger quantities of non-mineralized bone matrix (osteoid) experienced a reduction in relative osteoid volume, mean osteoid seam width, and total osteoid surface. Moreover, the use of time-spaced kinetic markers of mineralization (tetracycline) enabled us to demonstrate that CAPD usually decreased the amount of non-mineralized bone matrix by shortening mineralization lag time (that is, the interval from organic matrix deposition to its mineralization). The changes in the histomorphology appeared to occur independently of bone aluminum. These data indicate that CAPD generally enhances the mineralizing capacity of individual osteoblasts and suggests that such therapy is beneficial to the uremic skeleton.