Nephrology Dialysis Transplantation, Vol 13, Issue 90003 46-50, Copyright © 1998 by Oxford University Press
F Forero, E Altamirano and P Ramos
Renal osteodystrophy (ROD) is a multifactorial disease. Aluminium deposits
have been implicated in its physiopathology but iron deposits have seldom
been described. The purpose of this study was to investigate the presence
of iron on the mineralization front, in 70 patients with ROD. Their mean
age was 48±16 years, 36 were female, 34 male, 55 were admitted
on peritoneal dialysis (78.5%) and 15 to haemodialysis (21.5%), for a
period of 28±22 months. A bone biopsy was obtained from each
patient after double tetracycline labelling. Blood samples were also
obtained at the time of bone biopsy. The histomophometric analysis was
performed following the criteria of Sherrard et al.,
with slight modifications; beside the usual stains, aluminium, iron and
amyloid stainings were done on all bone specimens. Biochemical findings
were: Ca 8.8±0.9 mg/dl, P 6.1±1.5 mg/dl; total
alkaline phosphatase 197±258; PTHm 4.9±4.05 ng/ml
(normal 0.4-0.7 ng/ml), calcitonin 11±6 pg/ml (normal 1-26
pg/ml). Osteitis fibrosa was found in 31 patients (44.28%), mixed bone
disease in two patients (2.28%); mild bone disease in 20 subjects (28.57%),
adynamic bone lesion in 15 cases (21.42%) and osteomalacia in two patients
(2.28%). Iron deposits were found on the mineralization front in 43
patients (61.4%); in 17, the percentage was <25 and, in 26,
>25%. The iron deposits in the osteitis fibrosa group were highly
significant (25/31). The aluminium deposit at the mineralization front was
observed in eight patients (11.4%); in all but one, the percentage of this
metal was <10%. Amyloid deposits were negative in all cases. The
results show; (i) a Mexican population with ROD, present a highly
significant incidence of siderosis on the bone mineralization front; (ii)
in contrast, the aluminium deposits in this group of patients is lower than
that reported in other series, and (iii) the spectrum of RO in this Mexican
population is similar to that reported in other studies.Keywords:
aluminium bone deposits; bone iron overload; iron bone deposits;
renal osteodystrophy
ORIGINAL ARTICLES
High frequency of iron bone deposits in a Mexican population with renal osteodystrophy
Departamento de Patologia y Metabolismo Mineral Oseo, Hospital Mocel and Departamentos de Nefrologia del Hospital de Especialidades del C.M.N. Siglo XXI, IMSS, Instituto Nacional de la Nutricion Salvador Zubiran, Mexico; Corresponding author address: Hospital Mocel, Gelati No. 29, 4o. piso-407, Col. San Miguel Chapultepec, Mexico, DF, Mexico
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