Cortical bone microarchitecture in dialysis patients

Benillouche, Eva; Ostertag, Agnes; Marty, Caroline; Torres, Pablo Ureña; Cohen-Solal, Martine

Affiliations

¹Department of Rheumatology, Lariboisière Hospital, Paris, France

²INSERM U1132, Université de Paris, Hôpital Lariboisière (APHP), Paris, France

³Department of Nephrology and Dialysis, AURA, Saint-Ouen, France

Abstract and keywords

Background: The incidence of skeletal fractures is high in dialysis patients. Current available tools are insufficient to predict bone fragility. We analyzed the microarchitecture in patients on dialysis therapy using bone biopsies and peripheral microcomputed tomography.

Methods: We analyzed 12 trans-iliac bone biopsies of patients with recent fractures. Bone microarchitecture was assessed in the bone cores by histology (2D-), microcomputed tomography (3D-µCT), and high-resolution peripheral quantitative computed tomography (HR-pQCT) at the tibia.

Results: Trabecular bone volume/tissue volume was similar in 2D histology and 3D-µCT (p = 0.40), while lower in HR-pQCT (p < 0.01). There was no correlation in trabecular microarchitectural indices between 2-histology and 3D-µCT, or HR-pQCT. The 3D-µCT cortical thickness (Ct.Th) were positively correlated with 2D (p < 0.05), but with HR-pQCT (p = 0.33). Ct.Th was lower in patients with ≥2 vertebral fractures than with one fracture.

Conclusions: 3D-µCT is a reliable method for the measurement of cortical bone in bone biopsies. Prospective studies are awaited to address its value in discriminating fracture risk.

Keywords: Bone; Histology; micro-CT; High-resolution peripheral quantitative computed tomography; Fracture

Links

DOI: 10.1159/000510064

PubMed: 32911468

WoS: 000591386600009

History

Received: 2020-04-27

Accepted: 2020-07-08

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Cited By (2)

Year	Entry
2021	Ferreira AC, Cohen-Solal M, D’Haese PC, Ferreira A; European Renal Osteodystrophy (EUROD), an initiative of the CKD-MBD working group of the ERA-EDTA. The role of bone biopsy in the management of CKD-MBD. Calcif Tiss Int. April 2021;108(4):528-538.
2021	Pimentel A, Ureña-Torres P, Bover J, Fernandez-Martín JL, Cohen-Solal M. Bone fragility fractures in CKD patients. Calcif Tiss Int. April 2021;108(4):539-550.