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Pediatric Nephrology

, Volume 30, Issue 7, pp 1173–1179 | Cite as

Automated Greulich–Pyle bone age determination in children with chronic kidney disease

  • Eva Nüsken
  • Darja Imschinetzki
  • Kai-Dietrich Nüsken
  • Friederike Körber
  • Hans-Joachim Mentzel
  • Joachim Peitz
  • Martin Bald
  • Rainer Büscher
  • Ulrike John
  • Günter Klaus
  • Martin Konrad
  • Lars Pape
  • Burkhard Tönshoff
  • David Martin
  • Lutz Weber
  • Jörg Dötsch
Original Article

Abstract

Background

Growth restriction and retarded bone age are common findings in children with chronic kidney disease (CKD). We compared the automated BoneXpert™ method with the manual assessment of an X-ray of the non-dominant hand.

Methods

In this retrospective multicenter study, 359 patients with CKD stages 2–5, aged 2–14.5 (girls) or 2.5–17 years (boys) were included. Bone age was determined manually by three experts (according to Greulich and Pyle). Automated determination of bone age was performed using the image analysis software BoneXpert™.

Results

There was a strong correlation between the automatic and the manual method (r = 0.983, p < 0.001). The automatic method tended to generate higher bone age values (0.64 ± 0.73 years) in the younger patients (4–5 years) and to underestimate retardation or acceleration of bone age. The so-called “bone health index” (BHI) was reduced in comparison to the reference population. Bone health index standard deviation score (BHI-SDS) was not related to the stage of CKD, but weakly negatively correlated with plasma PTH concentrations (r = 0.12, p = 0.019).

Conclusions

BoneXpert™ allows an objective, time-saving, and in general valid bone age assessment in children with CKD. Possible underestimation of retarded or accelerated bone age should be taken into account. Validation of the BHI needs further study.

Keywords

Bone age Chronic kidney disease Renal osteopathy Greulich and Pyle BoneXpert™ 

Notes

Acknowledgements

The authors wish to thank Dr Hans-Henrik Thodberg, Holte, Denmark, for the fruitful discussion of the results, and NovoNordisk for financial support of this study. We would also like to thank the medical staff who assisted with data acquisition and care taking of the study patients.

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Copyright information

© IPNA 2015

Authors and Affiliations

  • Eva Nüsken
    • 1
  • Darja Imschinetzki
    • 1
  • Kai-Dietrich Nüsken
    • 1
  • Friederike Körber
    • 2
  • Hans-Joachim Mentzel
    • 3
  • Joachim Peitz
    • 1
  • Martin Bald
    • 4
  • Rainer Büscher
    • 5
  • Ulrike John
    • 6
  • Günter Klaus
    • 7
  • Martin Konrad
    • 8
  • Lars Pape
    • 9
  • Burkhard Tönshoff
    • 10
  • David Martin
    • 11
  • Lutz Weber
    • 1
  • Jörg Dötsch
    • 1
  1. 1.Department of Pediatrics and Adolescent MedicineUniversity of CologneCologneGermany
  2. 2.Department of Pediatric RadiologyUniversity of CologneCologneGermany
  3. 3.Department of Pediatric RadiologyUniversity Hospital JenaJenaGermany
  4. 4.Department of Pediatrics and Adolescent MedicineOlga-Hospital StuttgartStuttgartGermany
  5. 5.Department of Pediatrics and Adolescent MedicineUniversity of EssenEssenGermany
  6. 6.Department of Pediatrics and Adolescent MedicineUniversity Hospital JenaJenaGermany
  7. 7.Department of Pediatrics and Adolescent MedicineUniversity of MarburgMarburgGermany
  8. 8.Department of Pediatrics and Adolescent MedicineUniversity of MünsterMünsterGermany
  9. 9.Department of Pediatrics and Adolescent MedicineUniversity of HannoverHannoverGermany
  10. 10.Department of Pediatrics I, Centre for Pediatric and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany
  11. 11.Department of Pediatrics and Adolescent MedicineUniversity of TübingenTübingenGermany

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