Diagnosis of renal osteodystrophy in children with chronic renal failure

This study aimed to evaluate the potential of determining bone density using digital radiography in the detection of the bone changes of renal osteodystrophy as compared to biochemical findings [serum calcium, phosphorous and alkaline phosphatase]. This study included twenty five children with CRF aged 6 to 12 years of variable etiology; 14 of them were on dialysis and compared with 10 age and sex matched healthy controls. They were examined using digital radiography together with blood samples to measure serum calcium, phosphorous and alkaline phosphatase. 3 aluminium step wedges were attached to the film cassette to give a reference image on the radiograph. Panoramic radiographs were digitalized, stored and processed by a computer. A geometrically standardized rectangular area of interest was measured for each radiograph. Bone density using digital radiography adequately demonstrated bone status by determining bone density more conspicuously than do the biochemical findings. There were no significant differences detected between dialyzed and non-dialyzed patients so they were poured as one group. While, there was significant decrease in serum calcium and significant increase in serum phosphorous and alkaline phosphatase in patients group compared to controls group. Also, reduction of bone mineral density was detected in patients group compared to controls group and positive correlation was found between bone density of the whole sample and their serum calcium levels. No meaningful correlation could be established between bone mineral density and duration of dialysis. The study concluded that bone density using digital radiography is a potentially useful tool for evaluating the hone density and consequently the bone status of renal osteodystrophy