Renal osteodystrophy (ROD) also known as renal osteodystrophy, renal hypofunction mineral metabolic disorders, involving almost all end-stage renal failure patients, can be pided into broad and narrow sense of renal osteodystrophy in renal osteodystrophy in two categories. The generalized "renal osteodystrophy" refers to all and kidney related the etiology of bone or kidney related disease, such as renal tubular acidosis associated with rickets, nephrotic syndrome occurs when bone disease, so renal osteodystrophy in diagnosis room what kind of?
Diagnosis and differential diagnosis of renal osteopathy
Bone biopsy is one of the basic methods for the diagnosis and study of renal osteodystrophy is important. With the improvement and development of bone biopsy and histology, bone biopsy in clinical diagnosis and treatment more and more popular. When the glomerular filtration rate (GFR) decreased to below 40ml/min, renal biopsy to reflect the increase of PTH activity and bone the mineralization of obstacles. In addition, renal biopsy or diagnostic aluminum related bone damage (ARBD) diagnosis only reliable. At the same time, also has a certain significance for monitoring bone biopsy taking calcium three alcohol drugs in patients.
X-ray examination of bone
The classic bone X-ray examination method in the diagnosis of renal osteodystrophy. X-ray examination can be found in secondary hyperparathyroidism caused by subperiosteal resorption, pathological fracture, osteoporosis, rickets and osteomalacia, and secondary hyperparathyroidism or beta 2 microglobulin amyloidosis caused by bone cystic lesions. The type of tissue and bone transport by X-ray examination can not clear the renal osteodystrophy rate, is not conducive to the early diagnosis of bone disease.
Bone mineral density measurement
The application of bone mineral density measurement to reflect the content of bone mineral, can improve the sensitivity of renal osteodystrophy damage evaluation, but it is still not clear edge of renal damage in high transport, low transport or aluminum poisoning. So it can be used to observe the treatment of renal osteopathy follow-up.
Nuclear medicine examination
In recent years, with the development of nuclear medicine technology, using 99mTC labeled MDP (methylene diphosphonate) bone imaging in patients with renal osteodystrophy, can be found in fracture, false fracture local damage, and the high turnover bone disease caused by osteitis fibrosa and low transport osteopathy induced osteomalacia has the differential diagnosis value of aluminum poisoning. Renal osteodystrophy in bone imaging with low concentration of radioactive tissue, and soft tissue of high concentrated focus. Therefore, the use of nuclear medicine bone imaging this non traumatic examination is valuable for the diagnosis of renal osteodystrophy and typing.
Renal osteodystrophy also change, some biochemical indexes in clinic including PTH, alkaline phosphatase (AP), osteocalcin (BGP), 2-HS glycoprotein, insulin-like growth factor -1 (IGF-1), type VII procollagen peptide. The mechanism of expansion of some indicators in the pathogenesis of renal osteodystrophy in is still unclear. But, there is research on the diagnosis and contribute to renal osteodystrophy.