Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1982 Feb;35(2):125–134. doi: 10.1136/jcp.35.2.125

Quantitative bone histology in 38 patients with advanced renal failure.

J B Eastwood
PMCID: PMC497484  PMID: 7068905

Abstract

The clinical, biochemical, radiological and histological appearances of the bones of 38 patients with advanced renal failure are presented. Thirty-three patients had histological evidence of hyperparathyroidism and 17 also showed osteomalacia. Of five showing evidence of neither hyperparathyroidism nor osteomalacia, two had borderline osteopenia. There was an inverse correlation between the plasma calcium concentration and trabecular surface covered by osteoid with a tendency for those with the lowest concentrations of plasma calcium to show histological osteomalacia. There was an inverse correlation between extent of calcification front and both volume and surface extent of osteoid. No relation was found between plasma phosphorus concentration and any of the histological measurements made. Patients with radiological hyperparathyroidism had a lower calcium and higher plasma phosphorus than those without. Phalangeal sub-periosteal erosions were as common in those with histological osteomalacia as in those with histological hyperparathyroidism alone. There was no association between plasma alkaline phosphatase activity and type of bone disease. There was no correlation between the radiological second metacarpal index and the histological volume of cancellous iliac bone.

Full text

PDF
125

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaron J. E., Gallagher J. C., Anderson J., Stasiak L., Longton E. B., Nordin B. E., Nicholson M. Frequency of osteomalacia and osteoporosis in fractures of the proximal femur. Lancet. 1974 Feb 16;1(7851):229–233. doi: 10.1016/s0140-6736(74)92545-8. [DOI] [PubMed] [Google Scholar]
  2. BORDIER P., MATRAJT H., MIRAVET L., HIOCO D. MESURE HISTOLOGIQUE DE LA MASSE ET DE LA R'ESORPTION DES TRAV'EES OSSEUSES. Pathol Biol. 1964 Dec;12:1238–1243. [PubMed] [Google Scholar]
  3. Bordier P. J., Chot S. T., Eastwood J. B., Fournier A., de Wardener H. E. Lack of histological evidence of vitamin D abnormality in the bones of anephric patients. Clin Sci. 1973 Jan;44(1):33–41. doi: 10.1042/cs0440033. [DOI] [PubMed] [Google Scholar]
  4. Duursma S. A., Visser W. J., Njio L. A quantitative histological study of bone in 30 patients with renal insufficiency. Calcif Tissue Res. 1972;9(3):216–225. doi: 10.1007/BF02061960. [DOI] [PubMed] [Google Scholar]
  5. Ellis H. A., Peart K. M. Azotaemic renal osteodystrophy: a quantitative study on iliac bone. J Clin Pathol. 1973 Feb;26(2):83–101. doi: 10.1136/jcp.26.2.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ellis H. A., Peart K. M. Quantitative observations on mineralized and non-mineralized bone in the iliac crest. J Clin Pathol. 1972 Apr;25(4):277–286. doi: 10.1136/jcp.25.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ellis H. A., Pierides A. M., Feest T. G., Ward M. K., Kerr D. N. Histopathology of renal osteodystrophy with particular reference to the effects of 1alpha-hydroxyvitamin D3 in patients treated by long-term haemodialysis. Clin Endocrinol (Oxf) 1977 Dec;7 (Suppl):31s–38s. doi: 10.1111/j.1365-2265.1977.tb03359.x. [DOI] [PubMed] [Google Scholar]
  8. Exton-Smith A. N., Millard P. H., Payne P. R., Wheeler E. F. Method for measuring quantity of bone. Lancet. 1969 Nov 29;2(7631):1153–1154. doi: 10.1016/s0140-6736(69)92482-9. [DOI] [PubMed] [Google Scholar]
  9. Gryfe C. I., Exton-Smith A. N., Payne P. R., Wheeler E. F. Pattern of development of bone in childhood and adolescence. Lancet. 1971 Mar 13;1(7698):523–526. doi: 10.1016/s0140-6736(71)91126-3. [DOI] [PubMed] [Google Scholar]
  10. Gryfe C. I., Exton-Smith A. N., Stewart R. J. Determination of the amount of bone in the metacarpal. Age Ageing. 1972 Nov;1(4):213–221. doi: 10.1093/ageing/1.4.213. [DOI] [PubMed] [Google Scholar]
  11. Jowsey J. Calcium release from the skeletons of rachitic puppies. J Clin Invest. 1972 Jan;51(1):9–15. doi: 10.1172/JCI106802. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Malluche H. H., Ritz E., Lange H. P., Kutschera L., Hodgson M., Seiffert U., Schoeppe W. Bone histology in incipient and advanced renal failure. Kidney Int. 1976 Apr;9(4):355–362. doi: 10.1038/ki.1976.42. [DOI] [PubMed] [Google Scholar]
  13. Massry S. G., Coburn J. W., Lee D. B., Jowsey J., Kleeman C. R. Skeletal resistance to parathyroid hormone in renal failure. Studies in 105 human subjects. Ann Intern Med. 1973 Mar;78(3):357–364. doi: 10.7326/0003-4819-78-3-357. [DOI] [PubMed] [Google Scholar]
  14. Massry S. G., Stein R., Garty J., Arieff A. I., Coburn J. W., Norman A. W., Friedler R. M. Skeletal resistance to the calcemic action of parathyroid hormone in uremia: role of 1,25 (OH)2 D3. Kidney Int. 1976 Jun;9(6):467–474. doi: 10.1038/ki.1976.60. [DOI] [PubMed] [Google Scholar]
  15. Meema H. E., Meema S. Comparison of microradioscopic and morphometric findings in the hand bones with densitometric findings in the proximal radius in thyrotoxicosis and in renal osteodystrophy. Invest Radiol. 1972 Mar-Apr;7(2):88–96. doi: 10.1097/00004424-197203000-00004. [DOI] [PubMed] [Google Scholar]
  16. Merz W. A., Schenk R. K. Quantitative structural analysis of human cancellous bone. Acta Anat (Basel) 1970;75(1):54–66. doi: 10.1159/000143440. [DOI] [PubMed] [Google Scholar]
  17. Moorhead J. F., Tatler G. L., Baillod R. A., Varghese Z., Wills M. R., Farrow S. C. Effects of age, sex, and polycystic disease on progressive bone disease of renal failure. Br Med J. 1974 Dec 7;4(5944):557–560. doi: 10.1136/bmj.4.5944.557. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Parfitt A. M., Massry S. G., Winfield A. C. Osteopenia and fractures occurring during maintenance hemodialysis. A new form of renal osteodystrophy. Clin Orthop Relat Res. 1972 Sep;87:287–302. [PubMed] [Google Scholar]
  19. Schenk R. K., Merz W. A., Müller J. A quantitative histological study on bone resorption in human cancellous bone. Acta Anat (Basel) 1969;74(1):44–53. doi: 10.1159/000143361. [DOI] [PubMed] [Google Scholar]
  20. Simpson W., Ellis H. A., Kerr D. N., McElroy M., McNay R. A., Ppeart K. N. Bone disease in long-term haemodialysis: the association of radiological with histological abnormalities. Br J Radiol. 1976 Feb;49(578):105–110. doi: 10.1259/0007-1285-49-578-105. [DOI] [PubMed] [Google Scholar]
  21. Stanbury S. W., Lumb G. A. Parathyroid function in chronic renal failure. A statistical survey of the plasma biochemistry in azotaemic renal osteodystrophy. Q J Med. 1966 Jan;35(137):1–23. [PubMed] [Google Scholar]
  22. Ward M. K., Feest T. G., Ellis H. A., Parkinson I. S., Kerr D. N. Osteomalacic dialysis osteodystrophy: Evidence for a water-borne aetiological agent, probably aluminium. Lancet. 1978 Apr 22;1(8069):841–845. doi: 10.1016/s0140-6736(78)90191-5. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES