Technical approach to iliac crest biopsy.
Bone histomorphometry has been the gold standard in the evaluation and diagnosis of renal osteodystrophy. The recent new definition of renal osteodystrophy as chronic kidney disease-mineral and bone disorder has once again highlighted the use of bone biopsy as a powerful and diagnostic tool to determine skeletal abnormalities in chronic kidney disease. The procedure of iliac crest bone biopsy has been proved safe and associated with very minimal morbidity. In this review, the clinical indications, preparation, instrumentation, and potential complications are discussed. Because current biochemical markers are poor predictors of bone turnover, volume, and mineralization, a wider use of bone biopsy and histomorphometry will lead to a better understanding of the bone and mineral disorders that are associated with chronic kidney disease.
Hernandez
Joel D
JD
Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, A2-331, MDCC, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
Wesseling
Katherine
K
Pereira
Renata
R
Gales
Barbara
B
Harrison
Rick
R
Salusky
Isidro B
IB
D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000473:pathology; D006801:Humans; D007085:Ilium / Q000473:pathology*; D007674:Kidney Diseases / Q000150:complications; D010281:Parathyroid Hormone / Q000097:blood; D013048:Specimen Handling; D013752:Tetracycline
D010281:Parathyroid Hormone; D013752:Tetracycline