The use of bone mineral density measured by dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed microtomography in chronic kidney disease
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Chronic kidney disease (CKD) is a risk factor for fractures. The current evaluation of fracture risk is based upon the combination of various clinical factors and quantitative imaging of bone. X-ray-based tools were developed to evaluate bone status and predict fracture risk. Dual energy X-ray absorptiometry (DXA) is available worldwide. Longitudinal studies showed that low areal Bone Mineral Density (BMD) measured by DXA predicts fractures in the CKD population as it does in non uremic populations, with good specificity and moderate sensitivity. Peripheral quantitative computed tomography (pQCT) and high resolution pQCT are research tools which measure volumetric BMD at the tibia and radius. They are able to discriminate between the cortical and trabecular envelopes which are differentially affected by renal osteodystrophy. In CKD, a rapid thinning and increased porosity at the cortex is observed which is associated with increased the risk for fracture.
KeywordsDXA pQCT HRpQCT Fractures Chronic kidney disease Bone
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Conflict of interest
The author(s) declare that they have no competing interests.
This article does not contain any studies with human participants performed by any of the authors.
- 22.Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg MA (2011) Correlations between trabecular bone score, measured using antero-posterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J Clin Densitom 14(3):302–312CrossRefPubMedGoogle Scholar
- 25.Georgiou E, Virvidakis K, Douskas G, Lambrinoudaki I, Voudiklari S, Katsoudas S, Mountokalakis T, Proukakis C (1997) Body composition changes in chronic hemodialysis patients before and after hemodialysis as assessed by dual-energy X-ray absorptiometry. Metabolism 46(9):1059–1062CrossRefPubMedGoogle Scholar
- 28.Ketteler M, Elder G, Evenepoel P, Ix JH, Jamal SA, Lafage-Proust MH, Shroff R, Thadhani R, Tonelli M, Kasiske B, Wheeler DC, Leonard MB (2015) Revisiting KDIGO clinical practice guideline on chronic kidney disease-mineral and bone disorder: a commentary from a kidney disease: improving global outcomes controversies conference. Kidney Int 87(3):502–528CrossRefPubMedGoogle Scholar
- 29.Ketteler M, Block GA, Evenepoel P, Fukagawa M, Herzog CA, McCann L, Moe SM, Shroff R, Tonelli MA, Toussaint ND, Vervloet MG, Leonard MB (2017) Executive summary of the 2017 KDIGO chronic kidney disease-mineral and bone disorder (CKD-MBD) guideline update: what’s changed and why it matters. Kidney Int 92(1):26–36CrossRefPubMedGoogle Scholar
- 30.Yenchek RH, Ix JH, Shlipak MG, Bauer DC, Rianon NJ, Kritchevsky SB, Harris TB, Newman AB, Cauley JA, Fried LF (2012) Bone mineral density and fracture risk in older individuals with CKD. Health, aging, and body composition study. Clin J Am Soc Nephrol 7(7):1130–1136CrossRefPubMedPubMedCentralGoogle Scholar
- 32.Limori S, Mori Y, Akita W, Kuyama T, Takada S, Asai T, Kuwahara M, Sasaki S, Tsukamoto Y (2012) Diagnostic usefulness of bone mineral density and biochemical markers of bone turnover in predicting fracture in CKD stage 5D patients—a single-center cohort study. Nephrol Dial Transplant 27(1):345–351CrossRefGoogle Scholar
- 34.Pérez-Sáez MJ, Herrera S, Prieto-Alhambra D, Vilaplana L, Nogués X, Vera M, Redondo-Pachón D, Mir M, Güerri R, Crespo M, Díez-Pérez A, Pascual J (2017) Bone density, microarchitecture, and material strength in chronic kidney disease patients at the time of kidney transplantation. Osteoporos Int 11 (Epub ahead of print) Google Scholar
- 35.Clotet J, Martelli Y, Di Gregorio S, Del Río Barquero LM, Humbert LJ (2017) Clin Densitom. Structural parameters of the proximal femur by 3-dimensional dual-energy X-ray absorptiometry software: comparison with quantitative computed tomography. (Epub ahead of print) Google Scholar
- 40.Pelletier S, Vilayphiou N, Boutroy S, Bacchetta J, Sornay-Rendu E, Szulc P, Arkouche W, Guebre-Egziabher F, Fouque D, Chapurlat R (2012) Bone microarchitecture is more severely affected in patients on hemodialysis than in those receiving peritoneal dialysis. Kidney Int 82(5):581–588CrossRefPubMedGoogle Scholar
- 42.Iyer SP, Nikkel LE, Nishiyama KK, Dworakowski E, Cremers S, Zhang C, McMahon DJ, Boutroy S, Liu XS, Ratner LE, Cohen DJ, Guo XE, Shane E, Nickolas TL (2014) Kidney transplantation with early corticosteroid withdrawal: paradoxical effects at the central and peripheral skeleton. J Am Soc Nephrol 25(6):1331–1341CrossRefPubMedPubMedCentralGoogle Scholar
- 44.Zebaze R, Ghasem-Zadeh A, Mbala A, Seeman E (2013) A new method of segmentation of compact-appearing, transitional and trabecular compartments and quantification of cortical porosity from high resolution peripheral quantitative computed tomographic images. Bone 54(1):8–20CrossRefPubMedGoogle Scholar
- 46.Pelletier S, Confavreux CB, Haesebaert J, Guebre-Egziabher F, Bacchetta J, Carlier MC, Chardon L, Laville M, Chapurlat R, London GM, Lafage-Proust MH, Fouque D (2015) Serum sclerostin: the missing link in the bone-vessel cross-talk in hemodialysis patients? Osteoporosis Int 26(8):2165–2174CrossRefGoogle Scholar
- 47.Nuzzo S, Lafage-Proust MH, Martin-Badosa E, Boivin G, Thomas T, Alexandre C, Peyrin F (2002) Synchrotron radiation microtomography allows the analysis of three-dimensional microarchitecture and degree of mineralization of human iliac crest biopsy specimens: effects of etidronate treatment. J Bone Miner Res 17(8):1372–1382CrossRefPubMedGoogle Scholar
- 48.Bala Y, Depalle B, Douillard T, Meille S, Clément P, Follet H, Chevalier J, Boivin G (2011) Respective roles of organic and mineral components of human cortical bone matrix in micromechanical behavior: an instrumented indentation study. J Mech Behav Biomed Mater 4(7):1473–1482CrossRefPubMedGoogle Scholar
- 49.Hesse B, Varga P, Langer M, Pacureanu A, Schrof S, Männicke N, Suhonen H, Maurer P, Cloetens P, Peyrin F, Raum K (2015) Canalicular network morphology is the major determinant of the spatial distribution of mass density in human bone tissue: evidence by means of synchrotron radiation phase-contrast nano-CT. J Bone Miner Res 30(2):346–356CrossRefPubMedGoogle Scholar
- 50.Chang G, Boone S, Martel D, Rajapakse CS, Hallyburton RS, Valko M, Honig S, Regatte RR (2017) J Magn MRI assessment of bone structure and microarchitecture. Reson Imaging. (Epub ahead of print) Google Scholar