Correlation between 18F-Sodium Fluoride positron emission tomography and bone histomorphometry in dialysis patients

Validation and Comparison of [18F]NaF PET/CT Analysis Methods and Derivation of a Semi-population Input Function for Site Specific Measurements of Bone Formation in a Population with Chronic Kidney Disease Mineral and Bone Disorder

“…The mean K i -value is 0.034 ± 0.01 ml min − 1 ml − 1 using β-corrected IDAIFs as input to the mp-Patlak analysis. This is similar to results published for a chronic dialysis population (L 1 − 4 ) with a mean value of 0.039 ml min − 1 ml − 1 and, as expected, higher than the mean value of 0.028 ml min − 1 ml − 1 found for a hemodialysis population with suspected adynamic bone disease (L 1 − 4 ) [17,23].…”

“…A reason for such a high value may, in part, be that 72% of the population studied had untreated secondary hyperparathyroidism. Correspondingly, a new study by Aaltonen et al reported a mean value of 0.067 in dialysis patients with high turnover bone disease and 0.038 in dialysis patients with low turnover bone disease [17]. In comparison, our value of 0.042 ml min − 1 ml − 1 lies within the lower cut-off limit de ned in the Aaltonen study and above the value reported for two patients with hyperparathyroidism as found by Schiepers et al (0.034 ml min − 1 ml − 1 ).…”

“…Previous studies using 18 F-NaF PET/CT for dynamic bone examination have mostly studied female osteoporotic patients and excluded patients with CKD [16,12]. However, a recently published study of a CKD-MBD population also included 50% males with diabetic nephropathy as the most common cause of kidney failure (34%) [17].…”

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

“…156 Paget disease, characterized by increased osteoclast activity followed by increased osteoblast activity, and renal osteodystrophy, in which chronic kidney disease results in abnormally low or high bone turnover, are other disorders that may benefit from NaF-PET assessment. [162][163][164][165][166][167] NaF activity is higher in pagetic bones and has been found to decrease after 1 month of treatment with bisphosphonates, followed by a further decrease after 6 months. 166 Despite normal biomarkers, increased NaF activity was observed in most patients.…”

Focus on the Possible Role of Dietary Sodium, Potassium, Phosphate, Magnesium, and Calcium on CKD Progression

“…Among electrolyte derangements, besides sodium, commonly associated with body volume and blood pressure, a modified attention to serum levels of potassium is emerging, suggesting a modification of the traditional generic dietary restriction and careful discontinuation of Angiotensin Converting Enzyme-inhibitors to avoid potassium increments that could be more dangerous than mild-moderate hyperkalemia in chronic renal failure (CRF) patients [4]. Similarly, derangements in mineral metabolism (e.g., serum calcium and phosphate) are even more associated with hard cardiovascular outcomes, but also with bone disease and bone fractures, which are now recognized as risk factors of morbidity and mortality [5], claiming for novel appreciation with invasive and non-invasive diagnostic tools like bone biopsy [6], vertebral morphometry [7], Magnetic Resonance Imaging (MRI) [8], and Positron Emission Tomography (PET) [9]. In fact, the disorders of bone and minerals occurring early in renal failure might represent an interesting biologic model of accelerated aging [10] and of the associated progressive reduction of the glomerular filtration rate (GFR).…”