Bone demineralization in renal failure: a longitudinal study of the distal femur using photon absorptiometry

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Abstract
The bone mineral content (BMC) of the lower end of the femur was measured by photon absorptiometry in 87 patients with chronic renal failure. The γ-ray photon source was Am241. Serial measurements were obtained for up to two years. The mean BMC of the adult patients, comprising: 18 pre-dialysis (CRF), 41 chronic haemodialysis (CHD) and 19 renal transplant (RT) patients were all significantly lower than controls with the exception of the male CRF group. Two adults and one child on chronic haemodialysis showed a significant rate of bone loss (> 2% per year). In one of these adults the addition of daily oral 1 α hydroxycholecalciferol was associated with no further reduction in BMC. Two children and one adult on chronic haemodialysis showed a significant rate of increase in BMC (> 2% per year). This adult had had a tendency to loss of BMC on standard CHD treatment but after receiving parenteral 1,25 dihydroxycholecalciferol three times weekly showed a significant rate of increase in BMC. No CRF or RT patient had a significant rate of loss of BMC on serial measurement. Two adults and one child with CRF had a significant rate of increase in BMC on standard treatment.