title: Significance of minimodeling in dialysis patients with adynamic bone disease.
abstract: BACKGROUND
  We previously concluded from histomorphometric analysis that minimodeling contributes to bone formation in adynamic bone disease in patients with primary hypoparathyroidism. Presently we investigated whether this mechanism might be peculiar to adynamic bone disease.
  
  
  METHODS
  We histomorphometrically analyzed bone specimens obtained at biopsy or autopsy from 26 maintenance hemodialysis patients with hyperparathyroidism necessitating parathyroidectomy (group A) and from 27 dialysis patients with hypoparathyroidism (group B); respective mean ages were 60 +/- 7 years vs. 64 +/- 8 years; dialysis duration 14 +/- 6 years vs. 11 +/- 9 years; and serum intact parathyroid hormone (PTH) 1205 +/- 439 pg/mL vs. 41 +/- 27 pg/mL. Group B was divided further into outpatient and inpatient subgroups.
  
  
  RESULTS
  By histomorphometry, group A patients were diagnosed with osteitis fibrosa, and those in group B with adynamic bone disease. Minimodeling bone volume and minimodeling bone number were significantly greater in group B than group A (P= 0.0028 and P= 0.0008, respectively). Minimodeling bone volume correlated significantly and positively correlated with total bone volume in group B (P= 0.0016), but not in group A. In group B, minimodeling bone volume and total bone voluem were greater in outpatients than inpatients (P < 0.0001 and P= 0. 025, respectively). Minimodeling bone volume and total bone volume showed significant negative correlation with age in group B (P < 0.001 and P= 0.005, respectively).
  
  
  CONCLUSIONS
  Minimodeling might contribute to bone formation in dialysis patients with adynamic bone disease, in the absence of remodeling stimulated by parathyroid hormone (PTH), especially in relatively young patients with good activities of daily living.
authors: Nephrology Center, Toranomon Hospital, Tokyo, Japan. ubara@ma.kcom.ne.jp
authors: Yoshifumi
authors: Y
authors: Ubara
authors: Tetsuo
authors: T
authors: Tagami
authors: Syohei
authors: S
authors: Nakanishi
authors: Naoki
authors: N
authors: Sawa
authors: Junichi
authors: J
authors: Hoshino
authors: Tatsuya
authors: T
authors: Suwabe
authors: Hideyuki
authors: H
authors: Katori
authors: Fumi
authors: F
authors: Takemoto
authors: Shigeko
authors: S
authors: Hara
authors: Kenmei
authors: K
authors: Takaichi
mesh_terms: D000368:Aged; D001706:Biopsy; D016723:Bone Remodeling; D001842:Bone and Bones / Q000473:pathology; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000150:complications / Q000601:surgery; D007011:Hypoparathyroidism / Q000097:blood / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010002:Osteitis Fibrosa Cystica / Q000209:etiology / Q000473:pathology*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D006435:Renal Dialysis
chemical_list: D010281:Parathyroid Hormone