Bone demineralization in renal failure: a longitudinal study of the distal femur using photon absorptiometry

Overton, TR; Ds, Silverberg; Grace, Marcy B.; Wm, Rigal; Higgins, Mamie; Kb, Bettcher; Jb, Dossetor; Harley, H. R. S.; Hf, DeLuca

doi:10.1259/0007-1285-49-587-921

Cited by 12 publications

(6 citation statements)

References 12 publications

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“…The method of bone densitometry has proved to be a simple and sensitive method for the evaluation of BMC, especially used in hemodialysis patients [21][22][23][24]. In this study the methods of bone densitometry and routine laboratory tests were compared with bone morphological data evaluated from bone biopsy.…”

Section: Discussionmentioning

confidence: 99%

Studies of Bone Morphology, Bone Densitometry and Laboratory Data in Patients on Maintenance Hemodialysis Treatment

Lindergård

Johnell

Nilsson

et al. 1985

Nephron

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Bone morphological parameters of renal osteodystrophy such as abundance of osteoid surface, osteoid seam width index, calcification fronts, osteoclast activity and trabecular bone volume were studied in 71 patients on maintenance hemodialysis and compared with bone densitometry, laboratory and clinical data. Increased osteoclast activity (hyperparathyroidism) was by far the most common bone morphological finding. Patients with chronic pyelonephritis or polycystic kidney disease had more than double the amount of osteoid than patients with chronic glomerulonephritis. The trabecular bone volume seemed to be increased in most patients in contrast to the cortical bone volume which was decreased, judged from bone densitometry and previously from X-ray. Despite that patients with polycystic kidney disease were older, their trabecular volume was larger than in patients with glomerulonephritis. The bone mineral content evaluated by bone densitometry was low in most patients, and more associated with bone morphological signs of osteomalacia than with secondary hyperparathyroidism. Serum phosphate (S-Po₄) and serum parathyroid hormone (S-PTH) seemed to discriminate better between osteomalacia and secondary hyperparathyroidism than serum alkaline phosphatase (S-Alk. phosph.), which was elevated in both groups. Patients who had been bilaterally nephrectomized were no more abnormal than other patients, and they had lower S-Alk. phosph. The abundance of osteoclasts was found to be a predictor of future development of clinical secondary hyperparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Studies of Bone Morphology, Bone Densitometry and Laboratory Data in Patients on Maintenance Hemodialysis Treatment

Lindergård

Johnell

Nilsson

et al. 1985

Nephron

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“…T he metaca rpal bones, as well as the other phalanges, were assessed as described by Meema et al (25). Cortical bone mineral content was measured by 12s1 photon absorptiometry at the distal one-third site in the nondominant radius (27). The bone histology was evaluated di rectly using undecalcified biopsy samples obtained from the posterior iliac spine by means of a Vilaghy-ZeUerman needle (28 Bone metabolism In Crohn's disease TABLE4 patients, fractional calcium absorption from the gut was measured using a rad ioisotope method similar to that described by Chanard et al (33).…”

Section: Methodsmentioning

confidence: 99%

Disorders of Mineral and Bone Metabolism in Patients with Crohn's Disease

Westarp¹,

Thomson²,

Overton³

et al. 1987

Canadian Journal of Gastroenterology

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Crohn's disease is known to produce malabsorption of calcium and vitamin D which affect the skeleton. A variety of techniques were used to assess the prevalence of mineral and bone abnormalities in 53 consecutive patients with Crohn's disease. Twenty healthy controls were compared with 28 men and 25 women with Crohn's disease. In males, the mean corrected serum calcium concentration was elevated, the mean winter plasma 25-hydroxyvitamin D was low, as was the bone volume on biopsy and the fractional absorption of {7Ca. In females, the corrected serum calcium was also higher than in contro ls, as was the serum alkaline phosphatase activity. The female patients had significant decreases in both summer and winter plasma vitamin D leve ls, metacarpa l cortica l thickness and fractional absorption of 47 Ca. The disturbances in bone and mineral metabolism were generally mild and were not associated with use of glucocorticosteroids but were more severe in patients with a history of bowel resection. Thus, patients with C ro hn's disease are at risk of developing metabolic bone disease and consideration should be given for an assessment of the skeleton in patients with Crohn's disease. especially in women and in patients with previous ilea! resection. A battery of tests may be needed to exclude the diagnosis of metabo lic bo ne disease but a 25-hydroxyvitamin D assay and hand x·rays using industrial grade film are recommended as a valuable preliminary assessment.Can) Gastroe nterol 1987;1(1):l l-17 (23) and th e published normal population was used as the control groups with whom the Bone metabolism In Crohn's disease TABLE4 patients, fractional calcium absorption from the gut was measured using a rad ioisotope method similar to that described by Chanard et al (33). The protocol was as follows: on day 1 of the test the subject received 1.0 µCi47CaZ+ as calcium chloride in travenously after an 8 h fast. fuur hours later, while still fasting, the radioactivity in the concralaceral fo rearm was measured usi ng a low background, two crystal gamma ray spectrometer. On day 3 of the study, fo llowing another 8 h fast, residual activity in the forearm was measured immediately before the subject received an oral dose of 4 µCi47CaH together with 180 mg elemental calcium (as 10% gl uconate). Four hours following this oral dose, while still fasting, the forear m radioactiv ity was again measured. Fractional calcium absorption was calculated as fo llows:Plasma 25-hydroxyvitamin D and percentage fractional calcium absorption T he gamma ray spectrometer system, specially constructed for these measurements, was carefully calibrated and arm positioning devices were used to assure consistent repeat m easurements of fo rearm radioactivity. The radiation background of the gamma ray spectrometer system was low and stable a nd was screened against radioactivity from pans of the subject's body other than the measu red forearm . For normal subjects. the error in the measurement (including Table 2 Vol. 1 No. 1. October 1987 cou n ti...

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“…Bone mineral content (BMC) determination by means of single photon absorptiometry is considered as a noninvasive, sensitive technique for evaluating bone loss in uremic patients [1]. Several longitudinal BMC studies, in patients with chronic renal failure, were performed at the distal radius or the femural neck by means of single photon absorptiometry.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of Bone Mineral Content in Patients on Regular Hemodialysis

Eeckhout

Verbeelen

Sennesael

et al. 1989

Nephron

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Bone mineral content (BMC) was measured at the lumbar spine region by means of dual photon absorptiometry over a 3-year period in 20 patients on regular hemodialysis (RHD). Baseline mean BMC at the start of the monitoring was significantly decreased to 82.64% of predicted value (p < 0.05). During a 3-year follow-up mean BMC rose significantly to 90.61% (p < 0.05). Six patients received vitamin D supplements. Analysis of the data showed that rise of BMC was similar whether vitamin D was given or not. Our data suggest that (1) RHD inhibits bone loss at the lumbar spine level that occurred mainly before active uremia treatment and (2) the increment of BMC observed in this study can be attributed to the different site of measurement, the inaccuracy of the measurements by interference with soft tissue calcifications and the dialysis conditions

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Bone demineralization in renal failure: a longitudinal study of the distal femur using photon absorptiometry

Cited by 12 publications

References 12 publications

Studies of Bone Morphology, Bone Densitometry and Laboratory Data in Patients on Maintenance Hemodialysis Treatment

Studies of Bone Morphology, Bone Densitometry and Laboratory Data in Patients on Maintenance Hemodialysis Treatment

Disorders of Mineral and Bone Metabolism in Patients with Crohn's Disease

Monitoring of Bone Mineral Content in Patients on Regular Hemodialysis

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