Pathologic changes, mechanisms and diagnosis in renal bone disease.
OBJECTIVE
To investigate the incidence rate, pathologic changes, mechanisms and diagnostic methods in renal bone disease.


METHODS
The blood levels of carboxyterminal parpthyriod hormone (C-PTH), 1,25(OH)2D3, calcium and phosphate, aluminum in serum and bone tissue were measured. The bone biopsy and bone scan with 99m technetium methylene diphosphonate (99mTC-MDP) were performed in 51 uremic patients.


RESULTS
One hundred per cent of the patients had varying degree of pathologic changes in bone, in which 50.9% of the patients presented high-turnover bone disease, 7.8% of the patients presented low-turnover bone disease and 41.8% of the patients had mixed-type bone disease. The levels of serum C-PTH were predominently high in high-turnover bone disease while the levels of serum 1,25(OH)2D3 were significantly decreased in low-turnover bone disease. There was a high positive rate for the diagnosis of renal bone disease by bone scan with 99mTC-MDP.


CONCLUSIONS
The examination of bone pathology is the most valuable method for the diagnosis of renal bone disease. Bone scan with 99mTC-MDP has reference value when clinical conditions do not allow to make bone biopsy.
Zhu
P
P
Department of Nephrology, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Wang
G
G
Yu
Y
Y
Lou
D
D
Wang
S
S
Jia
J
J
Dong
D
D
D000328:Adult; D000368:Aged; D001706:Biopsy; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D007085:Ilium / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate; D014511:Uremia / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology
D013669:Technetium Tc 99m Medronate