Persistent Hypophosphatæmia and Osteomalacia in Dialysis Patients Not on Oral Phosphate-Binders: Response to Dihydrotachysterol Therapy

Ahmed, K.Y.; Wills, M. R.; Skinner, R.K.; Varghese, Zac; Meinhard, E; Baillod, R. A.; Moorhead, John F.

doi:10.1016/s0140-6736(76)92526-5

Cited by 43 publications

(8 citation statements)

References 8 publications

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“…Relative hypophosphatemia played, at least in part, a pathogenetic role in the genesis of the mineralization defect seen in 3 patients [No. 11,15,17] with osteomalacia [14][15][16]. Table III shows the correlations found between TBM assessed by CT and the different histomorphometric parameters.…”

Section: Resultsmentioning

confidence: 98%

Comparison of Histomorphometry and Computerized Tomography of the Spine in Quantitating Trabecular Bone in Renal Osteodystrophy

Torres

Lorenzo²,

González-Posada

1986

Nephron

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Computerized tomography (CT) has the advantage of allowing the isolation of trabecular bone of the axial skeleton, which is the more sensitive to metabolic changes. By means of single-energy X-ray CT we have devised a method for assessing trabecular bone mass (TBM) at L-4 vertebral body, which has an acceptable reproductibility (CV = 2.76%). Normal values where obtained after studying 29 normal individuals from both sexes and different ages. In order to know if the method is accurate, TBM was assessed in 17 patients (6 with creatinine clearance < 6 ml/min and 11 on chronic hemodialysis), and in all of them the results were compared with the histomorphometry of the iliac crest bone biopsy. TBM assessed by CT correlated with trabecular bone volume (TBV; mineralized bone + osteoid) (r = 0.82; p < 0.001) and this correlation was not improved after adding the volume of marrow fibrosis to TBV. TBM assessed by CT also correlated with mineralized bone volume but at a lower level of significance (r = 0.72 ;p = 0.001), and no correlation was found with relative osteoid volume alone. These findings suggest that final CT value is an integral of mineralized bone and osteoid but with a higher influence of mineralized bone. Osteomalacia and osteitis fibrosa were seen in situations of normal, decreased, or increased TBM assessed by CT, although the 2 patients with severe osteosclerosis suffered osteomalacia. We conclude that the assessment of TBM by CT at the axial skeleton of uremic patients has an acceptable reproducibility and accuracy. Its potential role in the management of renal osteodystrophy by noninvasive means must be stablished with repetitive studies in the same subjects, as is suggested by preliminary reports.

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Section: Resultsmentioning

confidence: 98%

Comparison of Histomorphometry and Computerized Tomography of the Spine in Quantitating Trabecular Bone in Renal Osteodystrophy

Torres

Lorenzo²,

González-Posada

1986

Nephron

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“…Profound hypophosphataemia should also be avoided since it is associated with osteomalacia. 43 If the relation between predialysis concentrations of phosphate and histological indices of osteomalacia is causal (Fig. 6), it is important to note that theconcentrations ofplasma phosphate below which osteomalacia may be inducedare considerably higher than those associated with impaired mineralisation in patients with normal renal function.…”

Section: Renal Failurementioning

confidence: 99%

Osteomalacia and chronic renal failure.

Kanis¹

1981

J Clin Pathol

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“…An indirect effect of aluminum via a phosphorus-deple tion syndrome is possible [29,30] and has been claimed to explain the osteomalacic dialysis osteodystrophy of ure mic patients [31,32], However, none of our osteomalacic dialysis patients with high bone aluminum concentrations had evidence of phosphorus depletion [unpublished re sults], On the contrary, some of them had uncontrolled plasma phosphorus concentrations even though they were being prescribed high doses of oral aluminum-containing phosphate binders.…”

Section: Osteomalacic Dialysis Osteodystrophy: Role Of Aluminum Intoxmentioning

confidence: 88%

Dialysis Osteomalacia and Aluminum Intoxication

Drüeke¹

1980

Nephron

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Persistent Hypophosphatæmia and Osteomalacia in Dialysis Patients Not on Oral Phosphate-Binders: Response to Dihydrotachysterol Therapy

Cited by 43 publications

References 8 publications

Comparison of Histomorphometry and Computerized Tomography of the Spine in Quantitating Trabecular Bone in Renal Osteodystrophy

Comparison of Histomorphometry and Computerized Tomography of the Spine in Quantitating Trabecular Bone in Renal Osteodystrophy

Osteomalacia and chronic renal failure.

Dialysis Osteomalacia and Aluminum Intoxication

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