Metabolic abnormalities in patients treated with haemodialysis - skeletal scintigraphy and bone turnover markers

Renal osteodystrophy Is one of one the main problems in patients treated with haemodialysis. The aim of the study was a comparison between bone scintigraphy and biochemical markers of bone turnover. The study was performed in a group of 23 haemodialysed patients aged 33-72 years. In all patients serum concentrations of osteocalcin (BGP), intact parathyroid hormone (iPTH), β-2 microglobulin (β-2m), rT3, FT3, FT4, TSH were measured using RIA, IRMA and chemiluminescence methods. Whole - body bone scintigraphy was performed 2.5 h after injection of 740 MBq MDP99mTc. The quantification of bone images was performed using bone to soft tissue index - K. Index K was significantly higher in haemodialysed patients (HD) than in control group (GK) (p<0.01). In patients with renal osteodystrophy serum BGP, iPTH and β-2m concentrations were markedly elevated as compared with the upper range of normal values. On the other hand rT3, FT3, FT4, TSH levels did not show any abnormal changes. There were significant correlations between BGP and i PTH (r=0.762, p<0.001) and between BGP and rT3 (r=-0.718, p<0.001) and between iPTH and rT3(r=-0.607, p<0.01) and between i PTH and FT4 (r=-0.605, p<0.01). Significant correlations were found also between on one hand and i PTH and BGP levels on the other. A significant relationship was found between visual and quantitative evaluation of bone scintigraphy and biochemical bone turnover markers. The obtained results indicate that skeletal scintigraphy may be helpful in diagnostic of type of renal osteodystrophy. (author)