Korean Journal of Nephrology 1997;16(4):672-681.

말기신부전증 환자의 투석전 신성 골이영양증

신석균 , 김흥수 , 곽연식 , 하성규 , 신규태 , 김도현

Abstract

Renal osteodystrophy(ROD) is one of the major long term complications in patients with ESRD. It can also be seen in the initial stage of chronic renal failure. Most patients with ROD are asymptomatic and therefore a number of biochemical markers and noninvasive imaging techniques have been used for a diagnosis of different types of ROD. However the quantitative bone histomorphometry is still the gold standard method to make the definite diagnosis. We have studied 19 predialysis patients with ESRD from Nov. 1995 to Jan. 1996 at Ajou Univ. medical center. All patients underwent bone biopsies and serologic markers such as I-PTH, osteocalcin, total alkaline phosphatase and serum aluminum pre-and post-low- dose desferrioxamine were measured. There were 10 male and 9 female patients and their mean age was 42.9±12.5 years. On the basis of bone histomorpho- metry, there were 8 patients with mild lesion, 2 os- teitis firosa, 1 mixed, 1 osteomalacia, 5 aplastic bone disease and 2 normal findings. Intact PTH or osteo- calcin did not show any difference among the 6 groups. Intact PTH showed statistically significant correlation with osteoid area(r=0.67, P<0.01). There was no aluminum related bone disease among the 19 predialysis patients. In summary, mild lesion was the most common (42.1%) type among the renal osteodystrophy in end stage renal disease patients starting dialysis and serologic markers such as I-PTH and osteocalcin were not different among the groups. However, data from more patients are needed to verify our findings.