Increased bone strontium levels in hemodialysis patients with osteomalacia

• Published in: Kidney international Vol. 57; no. 3; pp. 1107 - 1114
• Main Authors: D'Haese, Patrick C., Schrooten, Iris, Goodman, William G., Cabrera, Walter E., Lamberts, Ludwig V., Elseviers, Monique M., Couttenye, Marie-M, De Broe, Marc E.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2000; Nature Publishing
• Subjects: Aged; Aluminum - analysis; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone and Bones - chemistry; bone histology; Calcium - analysis; Chronic Kidney Disease-Mineral and Bone Disorder - metabolism; dialysis; Emergency and intensive care: renal failure. Dialysis management; Female; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; mineralization; Osmolar Concentration; Osteomalacia - etiology; Osteomalacia - metabolism; Renal Dialysis - adverse effects; renal osteodystrophy; Strontium - analysis; trace metal; Zinc - analysis; dialysis; mineralization; trace metal; bone histology; renal osteodystrophy; Human; Pathophysiology; Hemodialysis; Diseases of the osteoarticular system; Nutrition disorder; Vitamin deficiency; Bone disease; Aluminium; Zinc; Strontium; Extrarenal dialysis; Cohort study; Complication; Bone; Osteomalacia; Nutritional status; Quantitative analysis
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1046/j.1523-1755.2000.00938.x

Increased bone strontium levels in hemodialysis patients with osteomalacia. In this study, we report on the association between increased bone strontium levels and the presence of osteomalacia in end-stage renal failure patients treated by hemodialysis. We performed a histologic examination and determined the strontium content and strontium/calcium ratios in bone biopsies of 100 hemodialysis patients recruited from various centers all over the world. Aside from the bone strontium concentration, the bone aluminum content was assessed. The bone zinc concentration, a nonrelevant element for bone toxicity, was also measured. Bone strontium levels and bone strontium/calcium ratios were increased in subjects with osteomalacia when compared with those with the other types of renal osteodystrophy. Bone strontium and bone calcium levels correlated with each other. The slope of the linear regression curve correlating these parameters was much steeper in the osteomalacic group (Y = 2.22X - 120) as compared with the other types of renal osteodystrophy (Y = 0.52X - 5.7). Within the group of patients with osteomalacia, bone strontium levels also significantly correlated with the bone aluminum content (r = 0.72, P = 0.018). No such correlation was found for the other types of renal osteodystrophy. The bone zinc concentration of subjects with normal renal function did not differ significantly from the values noted for the various types of renal osteodystrophy taken as separate groups, nor could increased bone zinc concentrations be associated with a particular bone lesion. Our data demonstrate an association between osteomalacia and increased bone strontium concentrations in dialysis patients. Further studies are warranted to establish whether strontium plays either a primary, secondary, or contributive role in the development of the latter type of renal osteodystrophy.