Static histomorphometry allows for a diagnosis of bone turnover in renal osteodystrophy in the absence of tetracycline labels

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  • Hanne Skou Jørgensen
  • Geert Behets, University of Antwerp
  • ,
  • Liesbeth Viaene, Department of Neurology AZ Groeninge
  • ,
  • Bert Bammens, KU Leuven
  • ,
  • Kathleen Claes, KU Leuven
  • ,
  • Bjorn Meijers, KU Leuven
  • ,
  • Maarten Naesens, KU Leuven
  • ,
  • Ben Sprangers, KU Leuven
  • ,
  • Dirk Kuypers, KU Leuven
  • ,
  • Patrick C. D'Haese, University of Antwerp
  • ,
  • Pieter Evenepoel, KU Leuven

A bone biopsy with prior tetracycline labeling is the gold standard to diagnose renal osteodystrophy. In cases of missing tetracycline labels, it is still paramount to gain clinically relevant information from the extracted bone sample, by evaluating the static histomorphometry. This study investigates the diagnostic performance of static histomorphometry for the evaluation of high and low bone turnover. Transiliac bone biopsies taken pre- or post- kidney transplantation, of sufficient quality for a full histomorphometric analysis were included (n = 205). The cohort was randomly split to provide separate exploration and validation subsets. Diagnostic performance was evaluated by area under the receiver operator characteristics curve (AUC). All histomorphometric parameters were significantly different across categories of low (24%), normal (60%), and high (16%) bone turnover, and all were significant predictors of both high and low bone turnover (AUC 0.71–0.84). Diagnostic performance was very good for high turnover, as a combination of static parameters resulted in negative and positive predictive values (NPV and PPV) of 80% and 96%, respectively. For low turnover, the combined model resulted in PPV of 71% and NPV of 82%. We conclude that in the absence of tetracycline labels, static histomorphometry provide an acceptable alternative for a diagnosis of bone turnover in renal osteodystrophy.

Original languageEnglish
Article number116066
Number of pages7
Publication statusPublished - Nov 2021

Bibliographical note

Publisher Copyright:
© 2021

    Research areas

  • Bone histomorphometry, Chronic kidney disease, Chronic kidney disease – mineral and bone disorder, Kidney transplantation

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