FREQUENCY OF ADYNAMIC BONE-DISEASE AND ALUMINUM STORAGE IN ITALIAN UREMIC PATIENTS - RETROSPECTIVE ANALYSIS OF 1429 ILIAC CREST BIOPSIES

Background. Adynamic bone disease was initially attributed to aluminiu m intoxication in association with low circulating levels of parathyro id hormone. More recently adynamic bone disease has been described eve n in the absence of aluminium intoxication. Purpose of the study. It w as the purpose of this retrospective analysis of 1429 iliac crest biop sies sent to our laboratory from 1985 to 1994 by 41 Italian nephrology and dialysis centres to assess the frequency of adynamic bone disease and aluminium accumulation. Methods. Adynamic bone disease was diagno sed by histological and histodynamic (tetracycline labelling) analysis , on the basis of predetermined criteria. Aluminium accumulation was a ssessed by aluminon histochemical staining. Results. The frequency of adynamic bone disease was fairly constant at approximately 15% from 19 85 to 1994. In contrast, aluminium accumulation, defined as positive a luminon histochemical staining, decreased during the same period from 36% to 4%. Conclusions. Our data clearly show a dissociation of the in cidence of adynamic bone disease and aluminium accumulation in bone. A t least today, given the low prevalence of aluminium intoxication, fac tors other than aluminium are the main cause of adynamic bone disease.