A clinical assessment of the relationship between bone scintigraphy and serum biochemical markers in hemodialysis patients.
BACKGROUND
Renal osteodystrophy is a metabolic bone disease and a common complication of end-stage chronic renal failure and maintenance dialysis treatment. In this study, we examined the correlation between quantifying bone scintigraphy and serum biochemical markers in hemodialysis patients.


METHODS
Bone scintigraphy with technetium-99m-hydroxy-methylene-diphosphonate (99mTc-HMDP) was performed on 28 patients on maintenance hemodialysis. Bone scintigraphy was performed using a standard protocol and was quantified by setting regions of interest (ROIs) over selected regions. The bone-to-soft-tissue ratio (B/ST ratio) at each region was calculated in all patients. The B/ST ratios were then compared with serum biochemical markers.


RESULTS
The B/ST ratio for the skull correlated well with serum bone-specific alkaline phosphatase (BAP) (r = 0.735, p < 0.001), serum deoxypyridinoline (DPD) (r = 0.806, p < 0.001) and intact parathyroid hormone (intact PTH) (r = 0.701, p < 0.001). The B/ST ratio for the lumbar spine correlated with intact PTH (r = 0.387, p < 0.05) but not with serum BAP or serum DPD. The B/ST ratio for the femoral neck correlated with serum DPD (r = 0.431, p < 0.05) and intact PTH (r = 0.449, p < 0.05) but not with serum BAP.


CONCLUSIONS
Our data suggest that quantitative bone scintigraphy is a sensitive and useful method for evaluating bone metabolism in hemodialysis patients. The B/ST ratio for the skull may reflect changes of bone metabolism in hemodialysis patients.
Kurata
Seiji
S
Division of Nuclear Medicine and Department of Radiology, Kurume University School of Medicine, Fukuoka, Japan. seiji01@f4.dion.ne.jp
Ishibashi
Masatoshi
M
Nishida
Hidemi
H
Hiromatsu
Yuji
Y
Hayabuchi
Naofumi
N
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000097:blood* / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D006435:Renal Dialysis / Q000009:adverse effects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*
D000596:Amino Acids; D015415:Biomarkers; D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; C036020:deoxypyridinoline; D000469:Alkaline Phosphatase; D013669:Technetium Tc 99m Medronate