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Skip Navigation LinksJRI > Archive > January-March 2005, Volume 6, Issue 1 > Correlation between QUS of phalanx and DXA in assessment of bone structure in patients under hemodialysis



Volume 6, Issue 1, Number 21 / January-March
(pages 93-97)


Correlation between QUS of phalanx and DXA in assessment of bone structure in patients under hemodialysis




Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran

Department of Internal Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Department of Internal Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

1- Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran
2- Tehran University of Medical Sciences, Tehran, Iran

 Corresponding Author
Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran


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Abstract
Introduction: Many patients under hemodialysis, have osteopenia or even osteoporosis by the definition of the World Health Organization based on bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA), the standard method to assess BMD, is not always available. Quantit-ative ultrasound (QUS) of phalanx is an inexpensive, mobile, and radiation-free diagnostic alterna-tive. There is few data about correlation of this method with DXA in patients undergoing hemo-dialysis. The present study assessed the value of QUS in detecting changes in bone structure in pat-ients under hemodialysis compared with DXA. Materials and Methods: The patients had End Stage Renal Disease (ESRD) who was referred for Bone densitometry in BMD ward of EMRC. BMD of the hip (neck and total) and spine was measu-red using a GE-Lunar DXA device (DPX-MD). QUS of phalanx was done in all of them using a DBM-Sonic 1200 device. This device measures amplitude dependent speed of sound (Ad-SOS). SPSS (10) was used for statistical analysis. ROC curve was drawn to measure the sensitivity and specificity of QUS of phalanx. P- Value less than 0.05 were considered as significant. Results: In a cross-sectional analysis, 64 patients (37 men) with a mean age of 51.33+-15.20 years and mean dialysis time of 49.45+-45.62 months (2-180), were studied. DXA measurements established the diagnoses of osteoporosis in 31.3% in any of the total of femur or neck of femur or L2-L4 regions (25% in Neck , 18.8% in Total , 7.9% in L2-L4 regions).Using QUS of phalanx, osteoporosis diagnosed in 28.1% of patients . Using ROC curve, sensitivities of T-score ≤-2.5 of phalanx for diagnosing of osteoporosis in neck and total of hip and L2-L4 regions were respectively 37.5% and 50% and 80% and specificities were respectively 75% and 77% and 76%. Area under curve for neck, total and spine regions were 0.692 (P-value=0.022), 0.701 (P-value=0.031), 0.809 (P-value=0.023), respectively. Conclusions: QUS of phalanx can be recommended for screening osteoporosis among hemodialysed patients. Those suspected of osteoporosis, should be examined by additional DXA measurement for establishment of diagnosis.

Keywords: Osteoporosis, BMD, DXA, QUS, Hemodialysis


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References
  1. Lyhne N., Pedersen F.B. Changes in bone and mineral control during long- term CAPD. Indica-lion of a sex-dependent bone mineral loss.Nephral Dial Transplant.1995;10:395-8.
  2. Hussain R., Ahmed A., Soonro A.S. Frequency of metabolic bone disease in haemodialysis pafi-ents. J Pak Med Assoc. 1996;46:83-6.
  3. Taal M.W., Masud T., Green D., Cassidy M.J. Risk factors for reduced bone density in haemo-dialysis patients. Neph Dial Transplant.1999;14: 1922-8.
  4. Fontaine M.A., Albert A., Dubois B. Fracfure and bone mineral density in hemodialysis patie-nts. Clin Nephrol.2000;54:218-26.
  5. Nowak Z., Tlustochowicz W., Wankowicz Z., Bone mineral density in dialysis Patients: The optimal regior of interest depending on parathor-mone levels. Pol Merkceriusz Lek.2000;9:822-5.
  6. Nowak Z., Tlustchowioz W., Wankowicz Z. Bone mineral density in patients with irreversible renal failur trated with peritoneal dialysis. Pol Arch Med Wewn.2001;106:1035-40.
  7. Zayour D., Daouk M., Medawar W. Predictors of bone mineral density in patients on hemo-dialysis. Transplant Proc.2004;36:1297-301.
  8. WHO study group. Assessment of fracture risk and its application to screening for postmeno-pausal osteoporosis. Technical report series 843. Geneva: WHO,1994.
  9. Heaney R.P., Kanis J.A. The interpretation and utility of ultrasound measurement of bone. Bone. 1996; 18:491-2.
  10. Gluer C.C. Quantitative ultrasound techniques for the assessment of osteoporosis. Expert agree-ment on current status. J Bone Mineral Res.1997; 12:1280-1288.
  11. Mondry A., Rudiger Hetzel G., Willers R. Quantitative Heel Ultrasound in assessment of bone structure in renal transplant recipients. AmJ Kidney Dis.2001;37:932-937.
  12. Kosch M., Hausberg M., Link T., Kemkes M., Barenbrock M., Dietl K.H., Matzkies F, Rahn K. H., Kisters K. Measurement of skeletal status after renal transplantation by quantitative ultrasound. Clin Nephrol.2000;54:15-21.
  13. Pluskiewicz W., Adamczyk P., Drozdzowska B. Skeletal status in children, adolescents and young adults with end-stage renal failure treated with hemo-or peritoneal dialysis. Osteoporos Int.2002;13:353-7.
  14. Przedlacki J., Pluskiewicz W., Wieliczko M. Quantitative ultrasound of phalanges and dual-energy X-ray absorptiometry of forearm and hand in patients with end-stage renal failure treated with dialysis. Osteoporos Int.1999;10:1-6.
  15. Da Costa J.A., de Castro J.A., Foss M.C. The evaluation of renal osteodystrophy with cortical quantitative ultrasound at various bone sites. Ren Fail.2004;26:237-41.
  16. Peretz A., Penaloza A., Mesquita M. Quan-titative ultrasound and dual X-ray absorptiometry measurements of the calcaneus in patients on maintenance hemodialysis. Bone.2000;27:287-92.
  17. Pluskiewicz W., Adamczyk P. Drozdzowska B. Skeletal status in children and adolescents with chronic renal failure before onset of dialysis or on dialysis. Osteoporos Int.2003;14:283-8.
  18. Montagnani A., Gonelli S., Cepallaro C. Quantitative ultrasound in the assessment of skel-etal status in uremic patients. J Clin Densitom. 1999;2:389-95.
  19. Taal M.W., Cassidy M.J., Pearson D. Use-fulness of quantitative heel ultrasound compared with dual-energy X-ray absorptiometry in deter-mining bone mineral density in chronic haemo-dialysis patients. Neph Dial Transplant.1999; 14:1922-8.



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