A Novel Study on Non-invasive Assessment of Renal Osteodystrophy among Iranian Hemodialysis Patients

Renal osteodystrophy (ROD) is a common bone and mineral metabolism disorder in patients with end-stage renal disease (ESRD). This study aimed to determinate the frequency of the subtypes of ROD and evaluate the diagnostic value of biochemical as the well as radiographic markers for the diagnosis of ROD among hemodialysis patients in Golestan province of Iran. In this cross-sectional study, 50 patients with ESRD who referred to hemodialysis ward of 5th Azar Hospital in Gorgan city during 2016 were randomly selected and investigated. The biochemical and radiographic evaluations of ROD and its subtypes was performed, and then all patients underwent bone biopsy and histopathological study. Finally, the diagnostic value of the non-invasive methods was assessed. The mean age of patients was 59.5±12.0 years, and 27 patients (54.0%) were female. Also, 38 (76.0%) of ESRD patients had ROD, and 12 patients (24.0%) had no evidence of bone disorders. Among patients with ROD, 20 cases (52.6%) had the subtype of osteitis fibrosa cystica, five patients (13.2%) adynamic bone disease, 11 patients (28.9%) osteomalacia and two patients (5.3%) had mixed uremic osteodystrophy. The sensitivity, specificity, positive and predictive values and accuracy of the non-invasive methods for the diagnosis of ROD were 92%, 82%, 95%, 75%, and 90%, respectively. The results of this study showed that frequency of ROD in ESRD patients in Golestan province was high and the biochemical and radiographic markers have a high diagnostic value for the diagnosis of ROD as well as histopathological assessment.