Skip to main content
Log in

A clinical assessment of the relationship between bone scintigraphy and serum biochemical markers in hemodialysis patients

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Background

Renal osteodystrophy is a metabolic bone disease and a common complication of end-stage chronic renal failure and maintenance dialysis treatment. In this study, we examined the correlation between quantifying bone scintigraphy and serum biochemical markers in hemodialysis patients.

Methods

Bone scintigraphy with technetium-99m-hydroxy-methylene-diphosphonate (99mTc-HMDP) was performed on 28 patients on maintenance hemodialysis. Bone scintigraphy was performed using a standard protocol and was quantified by setting regions of interest (ROIs) over selected regions. The bone-to-soft-tissue ratio (B/ST ratio) at each region was calculated in all patients. The B/ST ratios were then compared with serum biochemical markers.

Results

The B/ST ratio for the skull correlated well with serum bone-specific alkaline Phosphatase (BAP) (r = 0.735, ? > 0.001), serum deoxypyridinoline (DPD) (r = 0.806, ? > 0.001) and intact parathyroid hormone (intact PTH) (r = 0.701, ? > 0.001). The B/ST ratio for the lumbar spine correlated with intact PTH (r = 0.387, ? > 0.05) but not with serum BAP or serum DPD. The B/ST ratio for the femoral neck correlated with serum DPD (r = 0.431, ? > 0.05) and intact PTH (r - 0.449, ? > 0.05) but not with serum BAP.

Conclusions

Our data suggest that quantitative bone scintigraphy is a sensitive and useful method for evaluating bone metabolism in hemodialysis patients. The B/ST ratio for the skull may reflect changes of bone metabolism in hemodialysis patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Malluche HH, Monier-Faugere MC. Renal bone disease 1990: An unmet challenge for the nephrologist.Kidney Int 1990;38:193–211.

    Article  PubMed  CAS  Google Scholar 

  2. Malluche HH, Langub MC, Monier-Faugere MC. The role of bone biopsy in clinical practice and research.Kidney Int 1999; 56 (Suppl 73): 20–25.

    Article  Google Scholar 

  3. Olgaard K, Heerfordt J, Madsen S. Scintigraphic skeletal changes in uremic patients on regular hemodialysis.Nephron 1976; 17:325–334.

    PubMed  CAS  Google Scholar 

  4. Elder G. Review. Pathophysiology and recent advances in the management of renal osteodystrophy.J Bone Miner Res 2002; 17:2094–2105.

    Article  PubMed  CAS  Google Scholar 

  5. Balon BP, Bren A. Bone histomorphometry is still the golden standard for diagnosing renal osteodystrophy.Clin Nephrol 2000; 54:463–469.

    Google Scholar 

  6. de Graaf P, Pauwels EKJ, Vos PH, Schicht IM, te Veide J, de Graeff J. Observations on computerized quantitative bone scintigraphy in renal osteodystrophy.Eur J Nucl Med 1984; 9:419–425.

    Article  PubMed  Google Scholar 

  7. Lien JWK, Wiegmann T, Rosenthall L, Kaye M. Abnormal99mTechnetium-tin-pyrophosphate bone scans in chronic renal failure.Clin Nephrol 1976; 6:509–512.

    PubMed  CAS  Google Scholar 

  8. Urena ?, de Vernejoul MC. Circulating biochemical markers of bone remodeling in uremic patients.Kidney Int 1999; 55:2141–2156.

    Article  PubMed  CAS  Google Scholar 

  9. Urena P, Hruby M, Ferreira A, Ang KS, de Vernejoul MC. Plasma total versus bone alkaline Phosphatase as markers of bone turnover in hemodialysis patients.J Am Soc Nephrol 1996; 7:506–512.

    PubMed  CAS  Google Scholar 

  10. Urena P, Ferreira A, Kung VT, Morieux C Simon P, Ang KS, et al. Serum pyridinoline as a specific marker of collagen breakdown and bone metabolism in hemodialysis patients.J Bone Miner Res 1995; 10:932–939.

    Article  PubMed  CAS  Google Scholar 

  11. Schmidt-Gayk H, Drueke T, Ritz E. Non-invasive circulating indicators of bone metabolism in uraemic patients: can they replace bone biopsy?Nephrol Dial Transplant 1996; 11:415–418.

    PubMed  CAS  Google Scholar 

  12. Rosenthall L, Kaye M. Technetium-99m-pyrophosphate kinetics and imaging in metabolic bone disease.J Nucl Med 1975; 16:33–39.

    PubMed  CAS  Google Scholar 

  13. Sy WM, Mittal AK. Bone scan in chronic dialysis patients with evidence of secondary hyperparathyroidism and renal osteodystrophy.Br J Radiol 1975; 48:878–884.

    Article  PubMed  CAS  Google Scholar 

  14. Wiegmann T, Rosenthall L, Kaye M. Technetium-99m-pyrophosphate bone scans in hyperparathyroidism.J Nucl Med 1977; 18:231–235.

    PubMed  CAS  Google Scholar 

  15. Fogelman I, Bessent RG, Gordon D. A critical assessment of bone scan quantitation (bone to soft tissue ratios) in the diagnosis of metabolic bone disease.Eur J Nucl Med 1981; 6:93–97.

    PubMed  CAS  Google Scholar 

  16. Francis MD, Ferguson DL, Tofe AJ, Bevan JA, Michaels SE. Comparative evaluation of three diphosphonates:in vitro adsorption (C-14 labeled) andin vivo osteogenic uptake (Tc-99m complexed).J Nucl Med 1980; 21:1185–1189.

    PubMed  CAS  Google Scholar 

  17. Dempster DW, Cosman F, Parisien M, Shen V, Lindsay R. Anabolic actions of parathyroid hormone on bone.Endocr Rev 1993; 14:690–709.

    Article  PubMed  CAS  Google Scholar 

  18. Johnson LC. Morphologic analysis in pathology: the kinetics of disease and general biology of bone. In:Bone biodynamics, Frost HM (ed), Boston; Little, Brown & Co., 1964: 543–654.

    Google Scholar 

  19. Schober HC, Han ZH, Foldes AJ, Shih MS, Rao DS, Balena R, et al. Mineralized bone loss at different sites in dialysis patients: Implications for prevention.J Am Soc Nephrol 1998; 9:1225–1233.

    PubMed  CAS  Google Scholar 

  20. de Jonge FAA, Pauwels EKJ, Hamdy NAT. Scintigraphy in the clinical evaluation of disorders of mineral and skeletal metabolism in renal failure.Eur JNucl Med 1991; 18:839–855.

    Google Scholar 

  21. Rosenthall L. Radiophosphate imaging and bone densitometry in renal osteodystrophy.Curr Opin Nephrol Hypertens 1993; 2:956–961.

    Article  PubMed  CAS  Google Scholar 

  22. Niwa T, Shiobara K, Hamada T, Miyazaki T, Tsukushi S, Uema et al. Serum pyridinolines as specific markers of bone resorption in hemodialyzed patients.Clin Chimica Acta 1995; 235:33–40.

    Article  CAS  Google Scholar 

  23. Rosalki SB. Biochemical markers of bone turnover.Int J Clin Pract 1998; 52:255–256.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Seiji Kurata.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kurata, S., Ishibashi, M., Nishida, H. et al. A clinical assessment of the relationship between bone scintigraphy and serum biochemical markers in hemodialysis patients. Ann Nucl Med 18, 513–518 (2004). https://doi.org/10.1007/BF02984569

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02984569

Key words

Navigation