Renal osteodystrophy - diagnosis

Bone biopsy
Bone biopsy is one of the diagnostic and renal osteodystrophy important basic research methods. With improvements in technology and the development of bone biopsy and histology of bone biopsy in the diagnosis and treatment is becoming increasingly popular . When glomerular filtration rate (GFR) or less down to 40ml/min , PTH biopsy may reflect increased activity and bone mineralization disorders. In addition , the diagnostic biopsy or aluminum -related bone damage (ARBD) only reliable diagnosis. Meanwhile , bone biopsy in patients taking calcitriol drug monitoring also has some significance.
Bone X -ray examination
Bone X -ray examination of the classical method of making the diagnosis of renal osteodystrophy . Skeletal X -ray examination can be found under the periosteum of secondary hyperparathyroidism due to absorption , osteoporosis , pathologic fractures , rickets and osteomalacia , as well as secondary hyperparathyroidism or β2 microglobulin amyloidosis caused bone cystic lesions. However, X-ray examination alone can not clear the type of renal osteodystrophy and bone tissue transfer rate, is not conducive to the early diagnosis of bone disease .
Bone densitometry
Application to reflect the content of bone mineral density of bone minerals can improve the sensitivity of renal osteodystrophy damage evaluation , but there is still no clear edge line of high transport kidney damage , low transfer resistance is caused by aluminum poisoning. Can be used for follow-up treatment of renal osteodystrophy .
Nuclear medicine
In recent years, with the development of nuclear medicine technology, the use 99mTC labeled MDP (methylene diphosphonate) on bone scintigraphy in patients with renal osteodystrophy , can be found in fractures, fractures and other pseudo- local damage , bone disease and the type of high transport To osteitis and bone disease caused by low bone softening transporters have diagnostic value . Aluminum poisoning caused by renal osteodystrophy tissue radioactivity in bone imaging with low uptake , and soft tissue uptake of high hotspot . Therefore, the use of nuclear medicine bone scintigraphy , a non- invasive examination , diagnosis and classification of renal osteodystrophy has a certain value.
Biochemical indicators
Renal osteodystrophy in clinical biochemical indicators also be some changes , including PTH, alkaline phosphatase (AP), osteocalcin (BGP), α2-HS glycoprotein , insulin-like growth factor -1 (IGF-1) , Ⅶ procollagen extension peptides . Some indicators mechanisms in the pathogenesis of renal osteodystrophy is still unclear , but contribute to the diagnosis and study of renal osteodystrophy .