The spectrum of renal osteodystrophy in Argentina [Espectro bioquímico e histológico de la osteodistrofia renal en Argentina]

Abstract

Between 1994-2001 we have performed 57 bone biopsies for diagnostic purposes in symptomatic CRF patients. We analyzed here 52 samples where the material was optimal for study, and divided them into 2 periods according to when the biopsy was performed: 1994-1996 and 1997-2001, to verify changes in the spectrum of renal osteodystrophy. Mean serum values were: serum calcium 9.9 ± 1.8 mg/dl, phosphate 5.8 ± 3.2 mg/dl, alkaline phosphatase 693.9 ± 968.9 UI/L, iPTH 562.0 ± 598.5 pg/ml, serum aluminum 65.7 ± 79.3 ug/L and bone aluminum 22.8 ± 22.4 ug/g. Hyperparathyroidism was the most common histological diagnosis as severe in 13 patients (25%), or as mild in 14 (27%). Ten patients had osteomalacia (19%), adynamic bone disease was diagnosed in 5 (9.6%) and mixed renal osteodystrophy in 10 (19.2%). Low bone turnover patients showed higher bone and serum aluminum than high bone turnover patients. We observed a relative increment in high turnover bone disease in the later period (1997-2001) without changes in low turnover bone disease. These data showed a high prevalence of hyperparathyroidism and aluminumrelated low turnover bone disease, with no significant changes between the two time-periods analyzed here.Fil: Douthat, Walter Guillermo. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Garay, Gabriela. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: De Arteaga, Javier. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Fernández Martín, J.L. Universidad de Oviedo. Servicio de Metabolismo Óseo y Mineral, Instituto Reina Sodía de Investigación, Hospital Universitario Central de Asturias; EspañaFil: Cannata Andía, J.B. Universidad de Oviedo. Servicio de Metabolismo Óseo y Mineral, Instituto Reina Sodía de Investigación, Hospital Universitario Central de Asturias; EspañaFil: Massari, Pablo U. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; Argentin