Abstract
We measured the radial cortical bone mineral density (C-BMD), relative cortical area (RCA) and trabecular bone mineral density (T-BMD) by peripheral quantitative computed tomography to monitor the annual changes and changes after parathyroidectomy (PTX) for secondary hyperparathyroidism in hemodialysis patients. All patients with mid-region parathyroid hormone (PTH) higher than 40000pg/ml (Hi-PTH group) showed an annual decrease of C-BMD, although patients with PTH lower than 5000pg/ml (low-PTH group) did not. RCA in the Hi-PTH group also decreased time-dependently. Since some patients in the low-PTH group showed a marked decrease of RCA, bone strength may have decreased in these cases. Recovery of C-BMD after PTX was less than 10% and observed only in young patients, leading to the proposal that interventions such as PTX should be considered before significant cortical bone loss occurs. Recovery of RCA after PTX was greater than that of C-BMD, suggesting that RCA is a more sensitive marker to monitor bone changes after PTX. T-BMD did not change time-dependently or after PTX. Therefore, T-BMD is not a good parameter to evaluate bone change in dialysis patients.
