The incidence, distribution, and progression of arterial calcification in severe chronic renal disease were studied from 364 skeletal survey examinations in 152 patients (ages 15-60). The incidence increased from 30% in the 15-30 age group to 50% in the 40-50 group. The earliest and commonest site of calcification was the ankles, followed in frequency by the abdominal aorta, feet, pelvis, and hands and wrists. Progression occurred in 36% of the nondialyzed, 19% of the peritoneally dialyzed, 13% of the post-transplant, and 8% of the hemodialyzed patients.

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Periosteal, intracortical, and endosteal resorptive changes were evaluated in both hands and the proximal radius in 161 chronic renal-failure patients by microradioscopy, radiographic morphometry, and photodensitometry. These changes were compared to abnormalities found in skeletal surveys. A combination of microradioscopy and morphometry of hand bones was sufficiently sensitive for early detection of bone loss in renal osteodystrophy in 61% of the patients. Intracortical resorption in metacarpals appeared to be a sign of more advanced renal osteodystrophy than subperiosteal resorption in phalanges. Photodensitometric findings in the radius generally agreed with microradioscopic and morphometric findings in hand bones.