Abstract
Bone mineral content (∑GS), bone mineral density (μ′) and the second moment of area (I) were measured by the MD/MS method in 87 patients on maintenance dialysis. The relation of these indexes with age, sex, number of years of dialysis and bone metabolism-relate indexes were studied. Of these 87 patients, 64 who could be followed up for three years or longer were divided into three groups; I: parathyroidectomized (PTX); II: calcitonin+1 α-(OH)-D3; and III: 1 α-(OH)-D3 alone. Group III was further divided into three subgroups according to the total dose of drug given for three years: IIIa: ≥800μg; IIIb: 300-800μg; and IIIc: 300μg. The changes in ∑GS, μ′ and I were followed for three years and the therapeutic results were evaluated.
The ∑GS and μ′ were decreased with aging. This trend was specially marked in women. I was found maintained even in aged subjects. The ∑GS and μ′ decreased age-relatedly. There was a significant negative relation between the ∑GS and serum level of AI-P, as well as PTH. In group I, the ∑GS and I were remarkably improved in many patients, and the PTX was judged to be effective. However, in some patients, the μ′ decreased, which suggested a tendency to osteomalacia.
In group II, ∑GS, the μ′ and I increased, and the use of calcitonin and 1 α-(OH)-D3 in combination was thought to be useful therapy. In group IIIa, the ∑GS, μ′ and I were maintained, but, in group IIIb and IIIc, the ∑GS and μ′ tended to decrease, and this suggested that a sufficient dose of 1 α-(OH)-D3 was necessary to maintain bone mineral content.
The ∑GS, μ′ and I reflected the differences in therapeutic effect among these treatments for renal osteodystrophy. Therefore the MD/MS method was judged as useful to assess bone status including bone mass and bone strength in patients on dialysis.
