title: [Bone imaging in patient with chronic kidney disease: a new tool for managing renal osteodystrophy?].
abstract: Bone damage in patients with chronic kidney disease (CKD), in the spectrum of chronic kidney disease-mineral and bone disorders (CKD-MBD), represents a daily challenge for nephrologists. The impact of CKD on bone health may be immediate (biological equilibrium) or delayed (fractures and vascular calcifications). Histomorphometry remains the gold standard to evaluate bone but it is rarely perfomed in clinical practice. A real measurement of bone mineral density (BMD) by dual X-ray absorptiometry (DXA) is currently performed to evaluate bone mass. However, this technique presents some limitations. In 2000, the National Institute of Health (NIH) defined new "quality" criteria for the diagnosis of osteoporosis in addition to a decreased bone mass. Bone strength actually integrates two concepts: bone density and bone quality (i.e., microarchitectural organization, bone turnover, mineralization and microfractures). These quality criteria cannot be evaluated by DXA. New bone imaging techniques have thus been developed, leading to an improvement in bone evaluation.
authors.affiliation: Service de néphrologie et rhumatologie pédiatriques, centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, boulevard Pinel, 69677 Bron, France. j.bacchetta@laposte.net
authors.forename: Justine
authors.initials: J
authors.lastname: Bacchetta
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Boutroy
authors.forename: Pierre
authors.initials: P
authors.lastname: Delmas
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
mesh_terms: D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000175:diagnosis*; D006801:Humans; D014057:Tomography, X-Ray Computed