Double-photon Bone Densitometry in Dialyzed Patients
Jaroš A. 1 , Budíková M. 3 , Bartek J. 2 , Zadražil J. 1 Konečný K. 1 , Krejčí K. 1 ,
1 III. interní klinika LF UP a FN, Olomouc, přednosta prof. MUDr. V. Ščudla, CSc. 2 Oddělení klinické biochemie FN, Olomouc, přednosta doc. MUDr. J. Bartek, CSc. 3 Klinika nukleární medicíny FN, Olomouc, přednosta doc. MUDr. M. Mysliveček, CSc. |
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Summary:
In non-invasive diagnosis of renal osteodystrophy the levels of bone minerals and the extent of
bone turnover are evaluated. The contents of bone minerals are assessed quantitatively by diffe-
rent modalities of bone densitometry, among which the most accurate one is doubnle-energy bone
densitometry. So far no standard examination method was defined nor the most suitable portion
of the skeleton for densitometric examination. In order to find such an area and also to assess the
prevalence of bone demineralization, its severity and regional differences the authors made
a cross-sectional study of bone density in dialyzed patients.
The group comprised 45 patients, 24 men and 21 women subjected to regular dialyzation treat-
ment for 20-24 months. In al whole body bone densitometry was performed with evaluation of
regional densities of the trunk, upper and lowe extremities. At the same time the state of bone
turnover was assessed arbitrarily using values of serum concentrations of intact parathormone;
parathormone concentrations below 50 pg/ml were considered low, above 200 pg/ml high and
concentrations within the mentioned range as the normal bone turnover. In the group of patients
62 % had a high, 22 % a normal and 16 % a low bone turnover. The study provided evidence of
a significant reduction of bone density (Z score <-1) in 58 % of patients. In 92 % of patients demine-
ralization affected most and first the extremities. In 69 % it affected the lower extremities and in
23 % the upper ones. 8 % of the patients had the most severe affections in the area of the trunk.
This order of affliction was not influenced by bone turnover, sex and in women by age. The
diaphysis of long bones seems to be a representative examination area of the skeleton for dento-
metric measurements in patients with regular dialyzation treatment.
Key words:
Bone densitometry - Renal osteodystrophy - Haemodialysis
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