| Theme | Usefulness of bone biopsy in making a diagnosis of ROD -- Its significance and limits | |
|---|---|---|
| Title | Pathogenesis and diagnosis of aplastic bone in hemodialysis patients | |
| Publish Date | 2005/10 | |
| Author | Satoshi Kurihara | Kasukabe Naika Clinic |
| [ Summary ] | The terms “Adynamic bone” and “aplastic bone” are both applied to cases of very low bone turnover in renal osteodystrophy (ROD) and are important in relation to complications for dialysis patients with unknown etiology for which there is no adequate treatment. Definite diagnosis of aplastic bone is done by histomorphological measurements of materials obtained with bone biopsies after tetracycline labeling. This condition is characterized by lack of fibrous tissue, decreased osteoid volume and very low bone formation rates. Many risk factors are associated, such as advanced age, diabetes, peritoneal dialysis, active vitamin D treatment, calcium overloading, parathyroidectomy, aluminum intoxication, etc. There is a common factor with these states in that serum parathyroid hormone levels are aggressively suppressed. To prevent the occurrence of aplastic bone conditions, intact PTH levels should be maintained at about three to five times above the normal range (150 - 300pg / ml), because of the existence of skeletal resistance to PTH in dialysis patients. |
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