Table 2.
Mineralization abnormalities found on bone biopsy in children and young adults
| Authors, Year (reference) | Population (n) and CKD / dialysis status | Age (years) | Key Findings on bone biopsies | Mineralization abnormalities* |
|---|---|---|---|---|
|
Salusky et al. 1988 [74] |
PD (44) | 6–18 |
Normal histology in 16% Osteitis fibrosa in 39% Aplastic lesions in 11% Osteomalacia in 9% |
9% of participants Study prior to TMV criteria |
| Mathias et al. 1993 [75] | HD (21) | 16–19 |
High turnover disease in 38% Osteitis Fibrosa in 23% Adynamic bone in 28% |
19% of participants with mixed lesions Study prior to TMV criteria |
| Goodman et al. 1994 [76] | PD (14) | 13–14 |
Before calcitriol: Osteitis Fibrosa in 79% After calcitriol: Normal in 43% Adynamic in 43% Osteitis fibrosa in 7% Mixed in 7% |
7% of participants Study prior to TMV criteria |
| Yalçinkaya et al. 2000 [77] | PD (17) | 7–20 |
High turnover disease in 47% Low turnover disease in 29% Mixed in 24% |
24% of participants |
| Ziólkowska et al. 2000 [78] | HD (21), PD (30) | 7–15 |
Adynamic bone disease in 27% Normal bone in 37% Osteomalacia in 2% Hyperparathyroidism in 24% Mixed lesions in 10% |
12% of participants |
| Waller et al. 2008 [73] | Pre-Tx (11) | 7–16 |
Low bone turnover disease in 18% Mixed lesions in 27% Hyperparathyroidism in 36% |
81% of participants |
| Bakkaloglu et al. 2010 [59] | PD (161) | 0–20 |
Low turnover in 4% Normal turnover in 39% High turnover in 57% |
Abnormal mineralization in 48% |
| Wesseling-Perry et al. 2012 [46] | CKD2–5 (52) | 2–21 |
High bone turnover in: 13% with CKD3 29% with CKD 4/5 |
Defective mineralization in: 29% with CKD2 42% with CKD3 79% with CKD4/5 |
| Bacchetta et al. 2013 [79] | PD (33) | 2–21 |
Patients assigned to treatment with growth hormone vs not At baseline: High turnover in 58% Low turnover in 42% |
Mineralization lower in those with low bone turnover (p < 0.001) Overall mineralization lag time lower in patients treated with growth hormone (p = 0.03) |
| Nawrot-Wawrzyniak et al. 2013 [80] | HD (7), PD (11) | 3–16 |
At baseline: Low bone turnover 39% Normal turnover 22% |
Mineralization lag time shortened after treatment with growth hormone (p < 0.05) |
| Soeiro et al. 2020 [72] | CKD 5D | 0–16 |
Low turnover in 59% Normal turnover in 24% High turnover in 17% |
Defective mineralization in 29% |
*Prior to the TMV criteria for reporting bone biopsy results, the assumption was made that both osteitis fibrosa and mixed disease are characterized by increased turnover, but osteitis fibrosa has normal mineralization, whereas mixed disease has abnormal mineralization. Equally, osteomalacia and adynamic disease are states of decreased turnover, with abnormal mineralization in osteomalacia and acellularity in adynamic disease [68]. The mineralization rates in adynamic bone disease are subnormal, but for the purposes of this table, if prior to the TMV criteria, they have not been included in the total percentage of mineralization abnormalities[81]