Bone scan appearance and biochemical markers of the bone metabolism in hemodialysis patients / 대한내과학회지

ABSTRACT

BACKGROUND: The gold standard for a diagnosis of ROD is performing a bone biopsy. We need other non-invasive diagnostic techniques because of this procedure's invasiveness. In this study, we evaluated the value of a radionucleotide bone scan and the various biochemical markers for determining the bone metabolism in hemodialysis patients . METHODS: This study evaluated 118 hemodialysis patients who underwent 99mTc-MDP bone scanning and blood tests for such biochemical markers as osteocalcin and c-terminal telopeptide of type I collagen. Two nuclear medicine physicians read the bone scan images semi-quantitatively for six bone areas and the soft tissue, and they assigned a score of 0, 1 or 2 to the findings. RESULTS: The patients were categorized into 3 classes iPTH or =200 pg/mL. For the group with a iPTH > or =200 pg/mL, the Ca, P product, alkaline phophatase and osteocalcin levels were increased, and the serum aluminum level was decreased compared to the other groups. When the bone scans were analyzed, the sum of the bone uptake scores was higher in the group with an iPTH > or =200 pg/mL while the soft tissue uptake score was higher in the group with an iPTH <50 pg/mL. The most common type of patient was a patient with an iPTH <50 pg/mL, and adynamic bone disease may be the most prevalent type of ROD. CONCLUSIONS: The bone scan findings correlated with the iPTH level in hemodialysis patients. Bone scans can provide additional information if this is combined with other biological markers. We stillneed to confirm its usefulness by conducting a comparative study with using bone biopsy.