Effects of Age, Sex, and Polycystic Disease on Progressive Bone Disease of Renal Failure

Abstract

SummaryA study of 150 patients undergoing haemodialysis has shown that age had a striking effect on the radiological presentation of renal bone disease, erosions being common in the young and uncommon in older patients and vascular calcification showing opposite trends to this. Men aged 20 to 59 years had a greater tendency to develop erosions than did women in this age range. Examination of a group of 53 patients over a period of five years showed that the half time for the development of vascular calcification was 4'6 years, erosions 26-7 years, and fractures 6-9 years. Nine out of 16 polycystic patients matched for age and sex with 50 controls did not develop erosions and had consistently less vascular calcification than the controls when examined over a six-year period.

The influence of age and sex on bone resorption of secondary hyperparathyroidism in renal osteodystrophy

“…For the evaluation of changes in intracortical resorption, the results should be shown separately for males and females, and again the duration of follow-up should be comparable. It is also of interest that the incidence of subperiosteal resorption in all adult age groups was found to be considerably higher in the present study (21-72%, Table 5) than in those by Moorhead et al [1] (2-12%) and Kanis [2] (approximately 5-25%). Since it has been clearly shown that subperiosteal resorption is recognized earlier by magnification techniques (not used by the aforementioned authors) than by standard radiography [6,8,9], our finding of overall higher incidence is likely to be a reflection of this improved diagnostic sensitivity of our method.…”

“…The usefulness of detecting and monitoring the course of renal osteodystrophy by this or similar methods is now well documented [9,10,[21][22][23]. Finally, the differences between our results and those of Moorhead et al [1] and Kanis [2] could also be partly explained by differences in treatment modalities: whereas patients of Moorhead et al [1] had all been hemodialyzed, and those of Kanis [2] were nondialyzed patients, our subject material consisted predominantly of peritoneally dialyzed patients.…”

“…have shown that older patients suffering from chronic renal failure have a lower frequency of subperiosteal resorption of hyperparathyroidism than younger ones 11, 2]; the influence of the sex of the patients appears more uncertain [1,3,4]. Since magnification techniques of hand radiography were not consistently used in these studies, minor degrees of subperiosteal resorption were unlikely to be detected [5][6][7][8][9][10][11][12].…”

Management of Renal Cystic Disorders

“…)robably due in large measure to the fact that these patients have rather high hematocrit values. Another report suggests that patients with polycystic kidney disease may develop less vascular calcification and have a much more reduced incidence of bone erosion than hemodialysis patients with other disorders (87).…”

Technetium-99-Labelled Methylene Diphosphonate Uptake Scans in Patients with Dialysis Arthropathy

“…Patients on long-term haemodialysis suffer from renal osteodystrophy with calcium and phosphate imbalance which may lead to soft-tissue calcification [27,28]. This may represent another possible mechanism whereby arti cular isotope binding might occur.…”