Bone imaging and chronic kidney disease: will high-resolution peripheral tomography improve bone evaluation and therapeutic management?

摘要: Bone damage because of chronic kidney disease (CKD) represents a daily challenge for nephrologists. The impact CKD on bone health may be immediate (serum phosphocalcic disturbances) or delayed (bone fractures and vascular calcifications). Histomorphometry remains the gold standard to evaluate bone, but it is rarely performed in clinical practice. Areal measurement mineral density by dual x-ray absorptiometry routinely mass. However, this technique presents some limitations. In 2000, United States National Institutes Health defined new "quality" criteria diagnosis osteoporosis addition decreased strength actually integrates two concepts: quantity quality (i.e., microarchitectural organization, turnover, material properties such as mineralization, collagen traits, microdamage) that cannot evaluated absorptiometry. New three-dimensional, noninvasive bone-imaging techniques have thus been developed, e.g., high-resolution peripheral quantitative computed tomography. High-resolution tomography allows evaluation both volumetric microarchitecture different compartments at distal radius tibia. useful predicting assessing preventive therapeutic strategies patients. It should long-term, longitudinal follow-ups.