[Biochemical and histological spectrum of renal osteodystrophy in Argentina].
Between 1994-2001 we have performed 57 bone biopsies for diagnostic purposes in symptomatic CRF patients. We analyzed here 52 samples where the material was optimal for study, and divided them into 2 periods according to when the biopsy was performed: 1994-1996 and 1997-2001, to verify changes in the spectrum of renal osteodystrophy. Mean serum values were: serum calcium 9.9 +/- 1.8 mg/dl, phosphate 5.8 +/- 3.2 mg/dl, alkaline phosphatase 693.9 +/- 968.9 Ul/L, iPTH 562.0 +/- 598.5 pg/ml, serum aluminum 65.7 +/- 79.3 ug/L and bone aluminum 22.8 +/- 22.4 ug/g. Hyperparathyroidism was the most common histological diagnosis as severe in 13 patients (25%), or as mild in 14 (27%). Ten patients had osteomalacia (19%), adynamic bone disease was diagnosed in 5 (9.6%) and mixed renal osteodystrophy in 10 (19.2%). Low bone turnover patients showed higher bone and serum aluminum than high bone turnover patients. We observed a relative increment in high turnover bone disease in the later period (1997-2001) without changes in low turnover bone disease. These data showed a high prevalence of hyperparathyroidism and aluminum-related low turnover bone disease, with no significant changes between the two time-periods analyzed here.
Douthat
W G
WG
Sección Metabolismo Oseo, Servicio de Nefrología, Hospital Privado-Centro Médico de Córdoba, Carrera de Postgrado en Nefrología, Universidad Católica de Córdoba, Argentina. wdouthat@powernet.net.ar
Garay
G
G
de Arteaga
J
J
Fernández Martín
J L
JL
Cannata Andía
J B
JB
Massari
P U
PU
D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000535:Aluminum / Q000032:analysis; D001118:Argentina / Q000453:epidemiology; D015415:Biomarkers; D001706:Biopsy; D016723:Bone Remodeling; D001842:Bone and Bones / Q000737:chemistry / Q000473:pathology*; D002118:Calcium / Q000097:blood; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood
D015415:Biomarkers; D010281:Parathyroid Hormone; D010758:Phosphorus; D000535:Aluminum; D000469:Alkaline Phosphatase; D002118:Calcium