Ultrasound velocity of the tibia in patients on hemodialysis

The ultrasound propagation velocity along the cortical of the tibial diaphy sis was measured in 42 patients (30 men and 12 women) (age x +/- 1 SD: 48.7 +/- 18.3 yr; range: 20-86 yr of age) on maintenance hemodialysis and in 18 5 control subjects matched for age and sex using a SoundScan 2000 equipment . Tibial ultrasound velocity was significantly lower in patients than in ag e- and sex-matched controls (3698 +/- 251 vs 3917 vs 104 m/s; p < 0.001), a nd even lower in hemodialyzed women than in men, mainly owing to the very l ow values of postmenopausal women. The mean +/- 1 SD of Z-scores values wer e the following: total population: -2.8 +/- 3.8; men: -2.3 +/- 3.8; women: -3.2 +/- 1.9 (premenopausal women: -1.8 +/- 1.4 vs postmenopausal women: -4 .1 +/- 1.6, p < 0.001). A highly significant negative correlation between ultrasound velocity and i PTH and bone alkaline phosphatase levels was found. There was no correlatio n between ultrasound velocity and the duration of hemodialysis. In men, unl ike women, no correlation was found between ultrasound velocity and age. In summary, tibial ultrasound velocity is lower in patients on hemodialysis than in control subjects, indicating a significant deterioration of cortic al bone. This decrease is closely related to the severity of secondary hype rparathyroidism. Tibial ultrasound velocity appears to be a sensitive metho d to detect these changes.