Table 2.
Histomorphometric and imaging parameters in dialysis patients according to distribution of renal osteodystrophy categories–turnover-based (a) and unified TMV-based (b) classification
| a—Turnover-based classification | High turnover (n = 3) | Normal turnover (n = 7) | Low turnover (n = 16) | p value |
|---|---|---|---|---|
| BFR/BS (µm3/µm2/year) | 35.0 (33.9–39.3) | 24.8 (20.2–30.0) | 7.5 (53–12.5) | < 0.001 |
| Ac.f (1/year) | 0.82 (0.67–0.83) | 0.49 (0.46–0.57) | 0.19 (0.15–0.31) | < 0.001 |
| Oc.S/BS (%) | 3.5 (1.4–6.7) | 2.5 (1.4–3.3) | 0.8 (0.11–1.7) | 0.02 |
| Ob.s/BS (%) | 7.2 (3.2–16.9) | 4.9 (3.2–14.0) | 2.0 (0.2–4.6) | 0.005 |
| Mlt (d) | 31.4 (22.3–34.8) | 33.8 (25.5–35.9) | 57.6 (33.1–100.5) | 0.05 |
| MS/BS (%) | 9.5 (9.4–10.7) | 6.5 (5.1–9.2) | 2.9 (2.0–5.5) | 0.002 |
| O.th (µm) | 8.7 (7.2–10.0) | 7.4 (6.1–10.6) | 5.7 (5.0–6.8) | 0.02 |
| MAR (µm/day) | 1.01 (0.99–1.01) | 1.03 (0.8–1.2) | 0.7 (0.6–0.9) | 0.008 |
| OS/BS (%) | 38.4 (24.1–40.8) | 27.5 (20.9–36.6) | 24.8 (19.3–31.8) | 0.27 |
| ES/BS (%) | 4.0 (2.4–6.9) | 3.8 (2.8–4.8) | 1.6 (0.7–2.9) | 0.03 |
| OV/BV (%) | 6.8 (5.5–7.8) | 3.5 (3.4–5.7) | 3.0 (2.4–4.0) | 0.02 |
| BV/TV (%) | 18.2 (18.1–25.0) | 22.8(18.8–27.2) | 18.7 (14.1–24.9) | 0.56 |
| Mean Ki (L1-L4) mL/min/mL | 0.067 (0.055–0.077) | 0.053 (0.032–0.059) | 0.038 (0.031–0.045) | 0.02 |
| Mean FUR (hip) mL/min/mL | 0.065 (0.050–0.066) | 0.056 (0.041–0.073) | 0.039 (0.032–0.046) | 0.01 |
| b—Unified TMV-based classification | High turnover—HPT (n = 11) | Normal turnover—mild HPT/normal (n = 9) | Low turnover AD (n = 6) | p value |
|---|---|---|---|---|
| BFR/BS (µm3/µm2/year) | 26.0 (20.2–34.0) | 9.7 (7.5–16.3) | 5.2 (2.3–5.7) | < 0.001 |
| Ac.f (1/year) | 0.56 (0.46–0.67) | 0.25 (0.16–0.39) | 0.13 (0.11–0.17) | < 0.001 |
| Oc.S/BS (%) | 2.5 (1.4–3.5) | 0.9 (0.23–1.31) | 0.7 (0.001–1.9) | 0.01 |
| Ob.s/BS (%) | 4.9 (3.2–14.0) | 2.9 (2.0–4.0) | 0.12 (0.001–0.3) | < 0.001 |
| Mlt (d) | 33.8 (25.5–35.9) | 44.4 (30.3–79.6) | 106.7 (99.6.0–174) | 0.009 |
| MS/BS (%) | 6.6 (5.1–9.5) | 3.2 (2.6–6.9) | 1.9 (1.4–2.7) | < 0.001 |
| O.th (µm) | 7.4 (6.6–10.0) | 5.6 (4.5–6.7) | 5.5 (4.9–6.7) | 0.02 |
| MAR (µm/day) | 1.01 (0.83–1.1) | 0.7 (0.6–0.9) | 0.7 (0.3–0.8) | 0.007 |
| OS/BS (%) | 27.5 (22.0–37.5) | 23.2 (17.3–32.3) | 27.4 (19.4–34.7) | 0.60 |
| ES/BS (%) | 3.8 (2.8–4.8) | 1.9 (0.90–3.2) | 1.5 (0.09–2.1) | 0.01 |
| OV/BV (%) | 5.1 (3.4–6.1) | 3.6 (2.1–4.6) | 2.6 (2.2–5.2) | 0.09 |
| BV/TV (%) | 22.8 (18.2–27.2) | 17.7 (12.7–23.1) | 18.9 (14.7–25.8) | 0.38 |
| Mean Ki (L1-L4) mL/min/mL | 0.056 (0.051–0.067) | 0.039 (0.037–0.047) | 0.032 (0.026–0.037) | 0.003 |
| Mean FUR (hip) mL/min/mL | 0.060 (0.050–0.071) | 0.041 (0.035–0.049) | 0.032 (0.029–0.038) | 0.002 |
Data are presented as median (interquartile range)
In the turnover-based classification, Malluche´s reference values for normal turnover were used: BFR/BS 18–38 µm/y and Ac.f 0.49–0.74/year
In the unified TMV-based classification, reference values for normal turnover (Recker et co, mean ± 1SD) in men was: BFR/BS 3.6–18.8 µm/year and Ac.f 0.12–0.6, in postmenopausal women: BFR/BS 6–22 um/year and Ac.f 0.11–0.49/year and in premenopausal women: BFR/BS 3–13 µm/y and Ac.f 0.04–0.26/year
Mean Ki (L1-L4) reflects the fluoride activity in the PET scan in the lumbar spine and Mean FUR (hip) the fluoride activity at the anterior iliac crest. p < 0.05 is statistically significant
BFR/BS bone formation rate per bone surface, Oc.S/BS osteoclast surface per bone surface, Ob.S/BS osteoblast surface per bone surface, MAR mineral apposition rate, Mlt mineralization lag time, MS/BS mineralized surface per bone surface, O.th osteoid thickness, Ac.f activation frequency per year, OS/BS osteoid surface per bone surface, ES/BS erosion surface per bone surface, OV/BV osteoid volume of bone volume, BV/TV bone volume of tissue volume