title: Correlations between bone histopathology and serum biochemistry in uremic patients on chronic hemodialysis.
abstract: To define which noninvasive investigations are of value in predicting bone histology, we analyzed transiliac bone specimens (66 biopsies, 14 autopsies) from 80 uremic patients on chronic dialysis. Results were compared with values of different measurements of parathyroid hormone (PTH), alkaline phosphatase (APH), osteocalcin, calcitonin, baseline and post-deferroxamine (DFO) aluminium (Al),--beta 2 microglobulin, ferritin and bone mineral density. Among histomorphometric parameters, woven osteoid, active osteoblastic surface and resorption surface showed the best correlations with dynamic and biochemical marks of active bone metabolism. Among biochemical parameters, intact PTH and APH were better related to histomorphometric and dynamic bone parameters than other PTH measurements as well as osteocalcin, while calcitonin was related to no parameters. Stainable Al alone, and not total bone Al content was related to bone histology. Baseline Al was related to lamellar osteoid, while post-DFO Al was related to stainable Al. beta 2 microglobulin was positively related to active osteoid surface and ferritin was inversely related to the mineral apposition rate, while bone mineral density was related only to total bone volume. We conclude that, though definite diagnosis requires the use of histological methods, few simple biochemical parameters may offer insight to the bone metabolic status, useful to the physician in day to day clinical practice.
authors.affiliation: Department of Medical Sciences, University of Torino, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Canavese
authors.forename: S
authors.initials: S
authors.lastname: Barolo
authors.forename: L
authors.initials: L
authors.lastname: Gurioli
authors.forename: A
authors.initials: A
authors.lastname: Cadario
authors.forename: M
authors.initials: M
authors.lastname: Portigliatti
authors.forename: G
authors.initials: G
authors.lastname: Isaia
authors.forename: A
authors.initials: A
authors.lastname: Thea
authors.forename: M
authors.initials: M
authors.lastname: Marangella
authors.forename: P
authors.initials: P
authors.lastname: Bongiorno
authors.forename: A
authors.initials: A
authors.lastname: Cavagnino
authors.forename: C
authors.initials: C
authors.lastname: Peona
authors.forename: R
authors.initials: R
authors.lastname: Boero
authors.forename: M
authors.initials: M
authors.lastname: D'Amicone
authors.forename: R
authors.initials: R
authors.lastname: Cardelli
authors.forename: P
authors.initials: P
authors.lastname: Rossi
authors.forename: G
authors.initials: G
authors.lastname: Piccoli
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000535:Aluminum / Q000032:analysis; D015415:Biomarkers / Q000032:analysis*; D015519:Bone Density / Q000502:physiology*; D001862:Bone Resorption; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007085:Ilium / Q000378:metabolism / Q000473:pathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*; D014511:Uremia; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D001613:beta 2-Microglobulin; D005293:Ferritins; D000535:Aluminum