The renal osteodystrophy pattern in Brazil and Uruguay: an overview.
BACKGROUND
The prevalence of the types of renal osteodystrophy (ROD) has changed in the last two decades. This study evaluates the prevalence and determining factors of the types of ROD in two countries in South America.


METHODS
Symptomatic patients who underwent bone biopsies for diagnostic purposes (1985 through 2001) were included in the study. In Brazil, a total of 2340 patients were reviewed, 93.1% on hemodialysis (HD), and 6.9% on continuous ambulatory peritoneal dialysis (CAPD). In Uruguay, 167 patients on hemodialysis were included. Uncalcified bone samples were analyzed in order to diagnose the different types of ROD.


RESULTS
Comparing the 1980s to the 1990s, the prevalence of Brazilian patients with hyperparathyroid bone disease (HP) increased from 32.3% to 44.0%, while Al overload decreased from 61.3% to 42.4%. A logistic regression analysis showed that the main factors associated with HP included female gender, age of less than 40 years, black patients, longer time on dialysis, and absence of Al overload. In Uruguay, HP also increased over time from 31.8% to 70.5% (P < 0.05), while Al overload decreased from 42% to 27% (P < 0.05).


CONCLUSIONS
A better control of Al overload may lead to a change in histologic pattern, as evidenced by the increasing prevalence of HP.
Araújo
Sonia M Holanda Almeida
SM
Universidade Federal do Ceará, Brazil.
Ambrosoni
Pablo
P
Lobão
Rosélia R Santos
RR
Caorsi
Hena
H
Moysés
Rosa M A
RM
Barreto
Fellype Carvalho
FC
Olaizola
Inés
I
Cruz
Elisa A S
EA
Petraglia
Alicia
A
Dos Reis
Luciene M
LM
Duarte
Maria Eugênia
ME
Jorgetti
Vanda
V
Carvalho
Aluizio B
AB
D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000473:pathology; D001938:Brazil / Q000453:epidemiology; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000473:pathology; D007085:Ilium / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D014583:Uruguay / Q000453:epidemiology