Predictive value of 99mTc pyrophosphate bone scintigraphy for vitamin D trials in uraemia.
The usefulness of 99mTc-Pyrophosphate (99mTc-PPi) bone scintigraphy was evaluated in the follow up of 21 haemodialysed patients without clinical or radiological evidence of osteodystrophy. 99mTc-PPi bone scintigraphy was semi-quantitatively analysed using Fogelman's score. Patients were randomised to receive vitamin D analogues (1 alpha hydroxyvitamin D3 or dihydrotachysterol, n = 12) or to serve as controls (n = 9), both groups being given oral calcium supplements. Bone scintigraphy deteriorated in patients only on calcium therapy but not in patients treated by vitamin D-analogues. Vitamin D therapy reduced secondary hyperparathyroidism in all cases but induced rapid intoxication with normal doses in 4 of the 12 treated patients. Since intoxicated patients had significantly lower Fogelman's score than the patients who tolerated the treatment well, 99mTc-PPi bone scintigraphy is proposed as a screening test before vitamin D-analogues trials.
D001842:Bone and Bones / Q000000981:diagnostic imaging*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000000981:diagnostic imaging / Q000517:prevention & control; D004097:Dihydrotachysterol / Q000627:therapeutic use*; D011756:Diphosphates; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D006435:Renal Dialysis; D013667:Technetium; D016698:Technetium Tc 99m Pyrophosphate; D014511:Uremia / Q000000981:diagnostic imaging* / Q000628:therapy
D011756:Diphosphates; D006887:Hydroxycholecalciferols; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium; D004097:Dihydrotachysterol; C008088:alfacalcidol