High-resolution peripheral quantitative CT (HR-pQCT) is effective for clarifying bone microstructure pathology in patients with CKD, according to findings published in Renal Failure. Researchers examined bone microstructures at different CKD stages among 119 healthy men and 40 men admitted to the hospital for inpatient education or the start of hemodialysis, scanning the distal radius and tibia with HRpQCT. Cortical bone parameters were lower in the CKD group than in healthy controls. Tibial cortical and trabecular bone parameters— including cortical thickness, cortical area, trabecular volumetric bone mineral density, trabecular bone volume fraction, and trabecular thickness—varied between patients with CKD stage 5D and those with KD stages 4-5 (P<0.01). These differences were also seen between patients with stage 5 and stage 5D (P<0.017), but not between those with stage 4 and stage 5, indicating that bone microstructure quickly changed upon initiating hemodialysis. Patients with stage 5D had tibial microstructural impairment compared with patients with stages 4-5.
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