| [ Summary ] |
Bone biopsies after tetracycline double labeling treatments have been used as the golden standard for the diagnosis of bone types in ROD. Basically, ROD has been classified into five histological types (ostitis fibrosa, osteomalacia, mixed, mild and adynamic forms) based on measurements of three major indices, which are osteoid volume (OV/BV ; %), fibrous tissue volume (Fb. V/TV ; %) and bone formation rate (BFR/BV ; year). Guidelines issued by the National Kidney Foundation K/DOQI™ provide a recommendation for bone biopsies on patients who have (1) a pathological fracture without trauma, (2) 100 - 5OO pg/ml of serum intact-PTH levels with hyper calcemia, high serum alkaline phosphatase and/or bone pain of unknown etiology, or (3) a history of aluminum exposure and/or serum high aluminum levels.
In this paper, we present several interesting biopsy cases that had been treated in our dialysis unit, and we discuss how the bone biopsy is applied in the treatment of ROD in dialysis patients. |