Bone mineral status measured by direct photon absorptiometry in childhood renal disease
Chesney, R.W.; Mazess, R.B.; Rose, P.G.; Jax, D.K.
Pediatrics 60(6): 864-872
1977
ISSN/ISBN: 0031-4005 PMID: 600598 Document Number: 110140
Bone width (BW), bone mineral content (BMC) and their ratio (BMC:BW ratio) were measured serially by direct photon absorptiometry on the radius and ulna in 74 children with renal diseases. Values were compared with age-, sex-, height- and weight-matched controls. The s.d. from the mean in normal subjects was plus or minus 10%. Significant demineralization, more than -2 s.d. was found in 42% of all patients and in 75% with tubulointerstitial disease; 12 patients with nephrotic syndrome and 2 with systemic lupus erythematosus, all of whom were on prednisone and had serum creatinine less that 1.0 mg/100 ml, and 3 treated with anticonvulsants had significant demineralization. Severe demineralization, more the -3 s.d., was found in 4 rachitic patients with tubulointerstitial disease. Normal mineralization was present in 32 patients with primary glomerular diseases, 7 of whom had serum creatinine above 1.5 mg/100 ml. BMC declined with daily prednisone, but increased with alternate-day treatment in 7 patients. The study suggests that demineralization is more common in patients with tubulointerstitial disease and in patients with primary glomerular disease who are on prednisone or anticonvulsants. Photon absorptiometry seemed more useful than conventional radiography in assessing skeletal involvement in childhood renal disease.