title: Biopsy vs. peripheral computed tomography to assess bone disease in CKD patients on dialysis: differences and similarities.
abstract: Results from bone biopsy and high-resolution peripheral quantitative computed tomography (HR-pQCT) were compared in 31 CKD patients. There was an agreement mainly for cortical compartment that may represent a perspective on the fracture risk assessment. HR-pQCT also provided some clues on the turnover status, which warrants further studies.
  
  
  
  Chronic kidney disease (CKD) patients are at high risk of bone disease. Although bone biopsy is considered the best method to evaluate bone disease, it is expensive and not always available. Here we have compared, for the first time, data obtained from bone biopsy and HR-pQCT in a sample of CKD patients on dialysis.
  
  
  
  HR-pQCT and dual-energy X-ray absorptiometry (DXA) were performed in 31 CKD patients (30 on dialysis). Biopsies were analyzed by quantitative histomorphometry, and classified according to TMV.
  
  
  
  We have found an inverse correlation between radius cortical density measured by HR-pQCT, with serum, as well as histomorphometric bone remodeling markers. Trabecular density and BV/TV measured through HR-pQCT in the distal radius correlated with trabecular and mineralized trabecular bone volume. Trabecular number, separation, and thickness obtained from HR-pQCT and from bone biopsy correlated with each other. Patients with cortical porosity on bone histomorphometry presented lower cortical density at the distal radius. Cortical density at radius was higher while bone alkaline phosphatase was lower in patients with low turnover. Combined, these parameters could identify the turnover status better than individually.
  
  
  
  There was an agreement between HR-pQCT and bone biopsy parameters, particularly in cortical compartment, which may point to a new perspective on the fracture risk assessment for CKD patients. Besides classical bone resorption markers, HR-pQCT provided some clues on the turnover status by measurements of cortical density at radius, although the significance of this finding warrants further studies.
authors.affiliation: Renal Transplant Service, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: I D B
authors.initials: ID
authors.lastname: Marques
authors.affiliation: Renal Transplant Service, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.|Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: M J C L N
authors.initials: MJ
authors.lastname: Araújo
authors.affiliation: Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: F G
authors.initials: FG
authors.lastname: Graciolli
authors.affiliation: Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: L M Dos
authors.initials: LM
authors.lastname: Reis
authors.affiliation: Rheumatology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: R M
authors.initials: RM
authors.lastname: Pereira
authors.affiliation: Renal Transplant Service, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.|Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: M R
authors.initials: MR
authors.lastname: Custódio
authors.affiliation: Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Jorgetti
authors.affiliation: Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: R M
authors.initials: RM
authors.lastname: Elias
authors.affiliation: Renal Transplant Service, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: David-Neto
authors.affiliation: Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil. rosa.moyses@uol.com.br.|Universidade Nove de Julho (UNINOVE), Rua Iperoig, 690 ap 121, São Paulo, SP, 05016-000, Brazil. rosa.moyses@uol.com.br.
authors.forename: R M A
authors.initials: RM
authors.lastname: Moysés
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D001706:Biopsy; D015519:Bone Density / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D010281:Parathyroid Hormone / Q000097:blood; D011884:Radius / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D015203:Reproducibility of Results; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D010281:Parathyroid Hormone
keywords: Bone biopsy; Chronic kidney disease; Cortical density; DXA; Dialysis; HR-pQCT