腎と骨代謝 Vol.32 No.1(3)


特集名 尿毒症と骨
題名 透析患者の骨量と骨形態
発刊年月 2019年 01月
著者 住田 圭一 Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center
【 要旨 】 透析患者の骨量評価には,二重X線吸収測定法(dual energy X-ray absorptiometry;DXA)を用いた骨密度測定が一般的であるが,透析患者で問題となる骨質の評価は困難である.近年,高解像度末梢骨用定量的CT(high resolution peripheral quantitative CT;HR-pQCT)や海綿骨スコア(trabecular bone score;TBS)の普及によって,非侵襲的な骨微細構造の評価が可能となり,その有用性が実証されつつある.これらの骨質評価ツールの臨床応用とともに,透析患者の骨形態解析や骨折リスク評価においても新たなエビデンスが創成され,透析患者の予後改善につながることを期待したい.
Theme Uremia and bone
Title Bone mass and morphology in dialysis patients
Author Keiichi Sumida Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center
[ Summary ] Dual-energy X-ray absorptiometry (DXA) is the standard method of measuring bone mass, or bone mineral density (BMD), in patients with end-stage renal disease on dialysis. However, it is technically impossible to use BMD to assess bone quality, which is often altered in dialysis patients. Recent advances in radiological techniques, such as high resolution peripheral quantitative CT (HRpQCT) and trabecular bone score (TBS), have enabled us to noninvasively evaluate bone microstructures, the efficacy of which has been proven in clinical studies. We hope that the widespread availability of these emerging tools will lead to new innovative discoveries both in bone morphological analysis and in fracture risk prediction among patients receiving dialysis and ultimately contribute to improved outcomes.
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