title: Increased bone strontium levels in hemodialysis patients with osteomalacia.
abstract: BACKGROUND
  In this study, we report on the association between increased bone strontium levels and the presence of osteomalacia in end-stage renal failure patients treated by hemodialysis.
  
  
  METHODS
  We performed a histologic examination and determined the strontium content and strontium/calcium ratios in bone biopsies of 100 hemodialysis patients recruited from various centers all over the world. Aside from the bone strontium concentration, the bone aluminum content was assessed. The bone zinc concentration, a nonrelevant element for bone toxicity, was also measured.
  
  
  RESULTS
  Bone strontium levels and bone strontium/calcium ratios were increased in subjects with osteomalacia when compared with those with the other types of renal osteodystrophy. Bone strontium and bone calcium levels correlated with each other. The slope of the linear regression curve correlating these parameters was much steeper in the osteomalacic group (Y = 2.22X - 120) as compared with the other types of renal osteodystrophy (Y = 0.52X - 5.7). Within the group of patients with osteomalacia, bone strontium levels also significantly correlated with the bone aluminum content (r = 0.72, P = 0.018). No such correlation was found for the other types of renal osteodystrophy. The bone zinc concentration of subjects with normal renal function did not differ significantly from the values noted for the various types of renal osteodystrophy taken as separate groups, nor could increased bone zinc concentrations be associated with a particular bone lesion.
  
  
  CONCLUSIONS
  Our data demonstrate an association between osteomalacia and increased bone strontium concentrations in dialysis patients. Further studies are warranted to establish whether strontium plays either a primary, secondary, or contributive role in the development of the latter type of renal osteodystrophy.
authors.affiliation: Department of Nephrology-Hypertension, University of Antwerp, P/a University Hospital Antwerp, Edegem, Belgium. dhaese@uia.ua.ac.be
authors.forename: P C
authors.initials: PC
authors.lastname: D'Haese
authors.forename: I
authors.initials: I
authors.lastname: Schrooten
authors.forename: W G
authors.initials: WG
authors.lastname: Goodman
authors.forename: W E
authors.initials: WE
authors.lastname: Cabrera
authors.forename: L V
authors.initials: LV
authors.lastname: Lamberts
authors.forename: M M
authors.initials: MM
authors.lastname: Elseviers
authors.forename: M M
authors.initials: MM
authors.lastname: Couttenye
authors.forename: M E
authors.initials: ME
authors.lastname: De Broe
mesh_terms: D000368:Aged; D000535:Aluminum / Q000032:analysis; D001842:Bone and Bones / Q000737:chemistry*; D002118:Calcium / Q000032:analysis; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010018:Osteomalacia / Q000209:etiology* / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects*; D013324:Strontium / Q000032:analysis*; D015032:Zinc / Q000032:analysis
chemical_list: D000535:Aluminum; D015032:Zinc; D002118:Calcium; D013324:Strontium