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Bone assessment in children with chronic kidney disease: data from two new bone imaging techniques in a single-center pilot study

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Abstract

Bone damage in children with chronic kidney disease (CKD) is a challenge for pediatric nephrologists. Areal measurements of bone mineral density (BMD) by dual x-ray absorptiometry (DXA) have been routinely performed to assess bone mass but recent international guidelines have concluded that DXA was of less value in CKD. The aim of this study is to evaluate bone quality in CKD children using new bone imaging techniques in a pilot cross-sectional single-center study. We performed bone imaging (high-resolution peripheral quantitative computed tomography, HR-pQCT, XtremeCT, Scanco Medical AG, Switzerland), to assess compartmental volumetric BMD and trabecular microarchitecture in 22 CKD children and 19 controls. In seven younger patients (i.e., under 10 years of age), we performed bone texture analysis (BMA, D3A Medical Systems, France) in comparison to 15 healthy prepubertal controls. Among older children, CKD patients had significantly lower height and body weight without significant impairment of BMD and microarchitecture than healthy controls. In univariate analysis, there were significant correlations between cortical BMD and glomerular filtration rate (r = -0.46), age (r = 0.60) and body mass index (r = 0.67). In younger children, bone texture parameters were not different between patients and controls. Our results did not show significant differences between healthy controls and CKD children for compartmental bone densities and microarchitecture, but the small sample size and the heterogeneity of the CKD group require caution in the interpretation. Novel bone imaging techniques seem feasible in children, and further longitudinal studies are required to thoroughly explore long-term cardiovascular and bone consequences of phosphate-calcium metabolism deregulation during CKD.

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Acknowledgements

This work is dedicated to Pierre Delmas†.

Disclosure of interests

None. This work was supported by an educational grant from the Société Française de Pédiatrie / Archives de Pédiatrie (2007).

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Authors and Affiliations

  1. Service de Néphrologie et Rhumatologie Pédiatriques, Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69677, Bron, France

    Justine Bacchetta, Bruno Ranchin, Odile Basmaison & Pierre Cochat

  2. INSERM U831, Lyon, France

    Justine Bacchetta, Stéphanie Boutroy, Nicolas Vilayphiou & Anne Fouque-Aubert

  3. Université de Lyon, Lyon, France

    Justine Bacchetta, Stéphanie Boutroy, Nicolas Vilayphiou, Anne Fouque-Aubert & Pierre Cochat

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  1. Justine Bacchetta
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  2. Stéphanie Boutroy
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  3. Nicolas Vilayphiou
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  4. Bruno Ranchin
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  5. Anne Fouque-Aubert
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  6. Odile Basmaison
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  7. Pierre Cochat
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Correspondence to Justine Bacchetta.

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Bacchetta, J., Boutroy, S., Vilayphiou, N. et al. Bone assessment in children with chronic kidney disease: data from two new bone imaging techniques in a single-center pilot study. Pediatr Nephrol 26, 587–595 (2011). https://doi.org/10.1007/s00467-010-1745-1

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  • DOI: https://doi.org/10.1007/s00467-010-1745-1

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