Clinical studies of bone metabolism using a simple model of calcium tracer kinetics

Bone metabolism studies were performed in 44 subjects with and without bone disease using a calcium tracers kinetics model, the central feature of which is an expanding exchangeable calcium pool. In normal subjects the accretion rate and the exchangeable calcium pool ranged from 1.49 to 8.45 (mean 3.9 +/- 2.05) mg.d-1kg-1 and from 60 to 131 (mean 81.25 +/- 18.11) mg.kg-1, respectively. The patients with osteogenesis imperfecta. Pierre Marie's disease and one out of two cases of hypoparathyroidism had values which fell within the normal range. Both the accretion rate and the exchangeable calcium pool were significantly elevated in patients with Paget's disease and with hyperparathyroidism. Uremic patients with generalized bone lesions had accretion rates or both parameters elevated. As far as patients with successful renal transplant are concerned, the results suggest that this method is a very poor means for detecting bone disorders with only focal lesions. In contrast, the method can be very useful when persistent renal osteodystrophy or secondary hyperparathyroidism are suspected.