Renal Failure

Eighty-nine patients with chronic renal failure underwent bone density testing of the spine using QCT (90). Sixty-six were receiving long-term hemodialysis. In the 23 patients not on dialysis, spine BMD was 9% lower than predicted normal values but this difference was not statistically significant. In patients receiving dialysis however, the average z-score was -1.3. In 42 patients on dialysis who were followed over 8 months, spinal BMD by QCT decreased an average of 2.9%. Osteosclerosis was found in 11 patients on dialysis.

In a cross-sectional study, 45 patients on continuous ambulatory peritoneal dialysis (CAPD) were evaluated using DXA (91). Total body, spine, and proximal femur bone densities were assessed. BMDs were not significantly different from an age-matched control population. The authors concluded that the prevalence of decreased bone density was not increased in CAPD patients. They also noted that BMD in the lumbar spine, femoral neck, and Ward's area was increased compared to controls in patients with evidence of hyperparathyroid disease. The authors observed that the utility of DXA regional studies to detect osteodystrophy is limited by the confounding effects of hyperparathyroid osteosclerosis.

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