Quantitative ultrasound and dual X-ray absorptiometry measurements of the calcaneus in patients on maintenance hemodialysis

It has been suggested that quantitative ultrasound measurements (QUS), whic h reflect mainly bone density, could be influenced by bone micro-architectu re. The aim of the study was to assess whether the relationship of QUS to d ual X-ray absorptiometry (DXA) would reflect abnormalities of hone structur e observed in renal osteodystrophy. QUS and bone mineral density of the cal cancus (BMDc) were measured by DXA in 30 patients on maintenance hemodialys is and 34 age- and gender-matched controls. QUS parameters and BMDc were si gnificantly lower in hemodialysis patients than in controls (speed of sound [SOS] and broadband ultrasound attenuation [BUA], p = 0.030; stiffness, p = 0.003; BMDc, p = 0.006), Bone measurements were not correlated with serum parathyroid hormone (PTH). The regression lines of SOS, BUA, and stiffness to BMDe were not significantly different from that of the controls, When d ividing the patients into two subgroups according to their median PTA (203 pg/mL), the slopes of the regression lines of BUA to BMDe were significantl y different between these two subgroups (p = 0.052). The slope of the subgr oup with PTH less than or equal to 203 pg/mL, was significantly different f rom that of the controls (p = 0.030). In conclusion, QUS of the calcaneus c an be used for bone assessment in patients on maintenance hemodialysis. The differences in the slopes of patients with a less pronounced degree of hyp erparathyroidism compared with patients with a higher degree of hyperparath yroidism and to controls suggest that BUA of the calcaneus contains informa tion on bone complementary to DXA measured at the same site. The clinical r elevance of this finding is presently unclear. (C) 2000 by Elsevier Science Inc. All rights reserved.