Assessment of dual-energy x-ray absorptiometry measures of bone health in pediatric chronic kidney disease
Background Dual-energy X-ray absorptiometry (DXA) techniques are limited in childhood chronic kidney disease (CKD) by the confounding effect of short stature and opposing parathyroid hormone effects on trabecular and cortical bone. Peripheral quantitative computed tomography (pQCT) is not subject to...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2012-07, Vol.27 (7), p.1139-1148 |
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| creator | Griffin, Lindsay M. Kalkwarf, Heidi J. Zemel, Babette S. Shults, Justine Wetzsteon, Rachel J. Strife, C. Frederic Leonard, Mary B. |
| description | Background
Dual-energy X-ray absorptiometry (DXA) techniques are limited in childhood chronic kidney disease (CKD) by the confounding effect of short stature and opposing parathyroid hormone effects on trabecular and cortical bone. Peripheral quantitative computed tomography (pQCT) is not subject to these limitations.
Methods
Lumbar spine (LS) and whole-body (WB) DXA and tibia pQCT scans were obtained in 88 stage 4–5 CKD and >650 healthy participants, ages 5–21 years. Sex- and race-specific Z-scores were generated for bone mineral density (BMD) and bone mineral content (BMC) by DXA, relative to age and adjusted for height Z-score (LS-BMD-Z and WB-BMC-Z), and compared to pQCT Z-scores for trabecular BMD (TrabBMD-Z) for age and cortical BMC (CortBMC-Z) for age and tibia length.
Results
LS-BMD-Z [0.50 (95% C.I. 0.28, 0.73),
p
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| doi_str_mv | 10.1007/s00467-012-2116-x |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4532320</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A331925962</galeid><sourcerecordid>A331925962</sourcerecordid><originalsourceid>FETCH-LOGICAL-c639t-60c5bad08e354f7abb0938a81a237e5d9412638388ca39a7f1c0dc17c41d7bcf3</originalsourceid><addsrcrecordid>eNqFkl2L1DAUhoso7rj6A7yRgiDeZM1X2-RGGBa_YMEbhb0LaXo6k7FNxqRdpv_elK7rjIxILgI5z_uSc86bZS8JviIYV-8ixrysECYUUUJKdHiUrQhnFBEpbh9nKywZQZiT24vsWYw7jLEoRPk0u6CUFZhhvsp26xghxh7ckPs2b0bdIXAQNlN-QEFPua6jD_vB-h6GMOU96DgGiDNcewf5FnQ3bHPr8j00Vg_Bmtxsg3fp_mEbB1Pe2JhU8Dx70uouwov7-zL7_vHDt-vP6Obrpy_X6xtkSiYHVGJT1LrBAljB20rXdWpDaEE0ZRUUjeSElkwwIYxmUlctMbgxpDKcNFVtWnaZvV9892PdQ2NSa0F3ah9sr8OkvLbqtOLsVm38neIFo4ziZPD23iD4nyPEQfU2Gug67cCPUREuSyEY5-L_KCaVFFVJi4S-_gvd-TG4NIlEyaLEjAj5h9roDpR1rU9fNLOpWjNGJC1kSROFzlCbeXG6S1tpbXo-4a_O8Ok00FtzVvDmSLDsOPpuTDlw8RQkC2iCjzFA-zBngtUcUrWEVKWQqjmk6pA0r44X9KD4ncoE0AWIqeQ2EI5H9S_XX64N8XI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1095603189</pqid></control><display><type>article</type><title>Assessment of dual-energy x-ray absorptiometry measures of bone health in pediatric chronic kidney disease</title><source>MEDLINE</source><source>Springer Online Journals Complete</source><creator>Griffin, Lindsay M. ; Kalkwarf, Heidi J. ; Zemel, Babette S. ; Shults, Justine ; Wetzsteon, Rachel J. ; Strife, C. Frederic ; Leonard, Mary B.</creator><creatorcontrib>Griffin, Lindsay M. ; Kalkwarf, Heidi J. ; Zemel, Babette S. ; Shults, Justine ; Wetzsteon, Rachel J. ; Strife, C. Frederic ; Leonard, Mary B.</creatorcontrib><description>Background
Dual-energy X-ray absorptiometry (DXA) techniques are limited in childhood chronic kidney disease (CKD) by the confounding effect of short stature and opposing parathyroid hormone effects on trabecular and cortical bone. Peripheral quantitative computed tomography (pQCT) is not subject to these limitations.
Methods
Lumbar spine (LS) and whole-body (WB) DXA and tibia pQCT scans were obtained in 88 stage 4–5 CKD and >650 healthy participants, ages 5–21 years. Sex- and race-specific Z-scores were generated for bone mineral density (BMD) and bone mineral content (BMC) by DXA, relative to age and adjusted for height Z-score (LS-BMD-Z and WB-BMC-Z), and compared to pQCT Z-scores for trabecular BMD (TrabBMD-Z) for age and cortical BMC (CortBMC-Z) for age and tibia length.
Results
LS-BMD-Z [0.50 (95% C.I. 0.28, 0.73),
p
< 0.0001] and TrabBMD-Z [0.53 (0.27, 0.79),
p
< 0.0001] were greater in CKD, and WB-BMC-Z [–0.36 (–0.53, –0.19),
p
< 0.0001] and CortBMC-Z [–0.48 (–0.70, –0.27),
p
< 0.0001] were lower, compared to reference participants. Z-scores were correlated at trabecular (LS-BMD-Z and TrabBMD-Z:
R
= 0.36) and cortical (WB-BMC-Z and CortBMC-Z:
R
= 0.64) sites in CKD; similar to correlations in reference participants.
Conclusions
Lumbar spine and whole-body DXA suggested greater trabecular BMD and lower cortical BMC in CKD, consistent with pQCT results; however, correlations were modest. Studies are needed to identify methods that predict fracture in childhood CKD.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-012-2116-x</identifier><identifier>PMID: 22350304</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Absorptiometry, Photon ; Adolescent ; Age ; Bone and Bones - diagnostic imaging ; Bone Density ; Bones ; Child ; Child, Preschool ; Children ; Chronic illnesses ; Chronic kidney failure ; Density ; Diseases ; Female ; Fractures ; Hospitals ; Humans ; Kidney diseases ; Lumbar Vertebrae - diagnostic imaging ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Pediatrics ; Renal Insufficiency, Chronic - complications ; Standard scores ; Tomography ; Tomography, X-Ray Computed ; Urology ; Young Adult</subject><ispartof>Pediatric nephrology (Berlin, West), 2012-07, Vol.27 (7), p.1139-1148</ispartof><rights>IPNA 2012</rights><rights>COPYRIGHT 2012 Springer</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c639t-60c5bad08e354f7abb0938a81a237e5d9412638388ca39a7f1c0dc17c41d7bcf3</citedby><cites>FETCH-LOGICAL-c639t-60c5bad08e354f7abb0938a81a237e5d9412638388ca39a7f1c0dc17c41d7bcf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-012-2116-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-012-2116-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22350304$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Griffin, Lindsay M.</creatorcontrib><creatorcontrib>Kalkwarf, Heidi J.</creatorcontrib><creatorcontrib>Zemel, Babette S.</creatorcontrib><creatorcontrib>Shults, Justine</creatorcontrib><creatorcontrib>Wetzsteon, Rachel J.</creatorcontrib><creatorcontrib>Strife, C. Frederic</creatorcontrib><creatorcontrib>Leonard, Mary B.</creatorcontrib><title>Assessment of dual-energy x-ray absorptiometry measures of bone health in pediatric chronic kidney disease</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
Dual-energy X-ray absorptiometry (DXA) techniques are limited in childhood chronic kidney disease (CKD) by the confounding effect of short stature and opposing parathyroid hormone effects on trabecular and cortical bone. Peripheral quantitative computed tomography (pQCT) is not subject to these limitations.
Methods
Lumbar spine (LS) and whole-body (WB) DXA and tibia pQCT scans were obtained in 88 stage 4–5 CKD and >650 healthy participants, ages 5–21 years. Sex- and race-specific Z-scores were generated for bone mineral density (BMD) and bone mineral content (BMC) by DXA, relative to age and adjusted for height Z-score (LS-BMD-Z and WB-BMC-Z), and compared to pQCT Z-scores for trabecular BMD (TrabBMD-Z) for age and cortical BMC (CortBMC-Z) for age and tibia length.
Results
LS-BMD-Z [0.50 (95% C.I. 0.28, 0.73),
p
< 0.0001] and TrabBMD-Z [0.53 (0.27, 0.79),
p
< 0.0001] were greater in CKD, and WB-BMC-Z [–0.36 (–0.53, –0.19),
p
< 0.0001] and CortBMC-Z [–0.48 (–0.70, –0.27),
p
< 0.0001] were lower, compared to reference participants. Z-scores were correlated at trabecular (LS-BMD-Z and TrabBMD-Z:
R
= 0.36) and cortical (WB-BMC-Z and CortBMC-Z:
R
= 0.64) sites in CKD; similar to correlations in reference participants.
Conclusions
Lumbar spine and whole-body DXA suggested greater trabecular BMD and lower cortical BMC in CKD, consistent with pQCT results; however, correlations were modest. Studies are needed to identify methods that predict fracture in childhood CKD.</description><subject>Absorptiometry, Photon</subject><subject>Adolescent</subject><subject>Age</subject><subject>Bone and Bones - diagnostic imaging</subject><subject>Bone Density</subject><subject>Bones</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Chronic illnesses</subject><subject>Chronic kidney failure</subject><subject>Density</subject><subject>Diseases</subject><subject>Female</subject><subject>Fractures</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Pediatrics</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Standard scores</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed</subject><subject>Urology</subject><subject>Young Adult</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkl2L1DAUhoso7rj6A7yRgiDeZM1X2-RGGBa_YMEbhb0LaXo6k7FNxqRdpv_elK7rjIxILgI5z_uSc86bZS8JviIYV-8ixrysECYUUUJKdHiUrQhnFBEpbh9nKywZQZiT24vsWYw7jLEoRPk0u6CUFZhhvsp26xghxh7ckPs2b0bdIXAQNlN-QEFPua6jD_vB-h6GMOU96DgGiDNcewf5FnQ3bHPr8j00Vg_Bmtxsg3fp_mEbB1Pe2JhU8Dx70uouwov7-zL7_vHDt-vP6Obrpy_X6xtkSiYHVGJT1LrBAljB20rXdWpDaEE0ZRUUjeSElkwwIYxmUlctMbgxpDKcNFVtWnaZvV9892PdQ2NSa0F3ah9sr8OkvLbqtOLsVm38neIFo4ziZPD23iD4nyPEQfU2Gug67cCPUREuSyEY5-L_KCaVFFVJi4S-_gvd-TG4NIlEyaLEjAj5h9roDpR1rU9fNLOpWjNGJC1kSROFzlCbeXG6S1tpbXo-4a_O8Ok00FtzVvDmSLDsOPpuTDlw8RQkC2iCjzFA-zBngtUcUrWEVKWQqjmk6pA0r44X9KD4ncoE0AWIqeQ2EI5H9S_XX64N8XI</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Griffin, Lindsay M.</creator><creator>Kalkwarf, Heidi J.</creator><creator>Zemel, Babette S.</creator><creator>Shults, Justine</creator><creator>Wetzsteon, Rachel J.</creator><creator>Strife, C. Frederic</creator><creator>Leonard, Mary B.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120701</creationdate><title>Assessment of dual-energy x-ray absorptiometry measures of bone health in pediatric chronic kidney disease</title><author>Griffin, Lindsay M. ; Kalkwarf, Heidi J. ; Zemel, Babette S. ; Shults, Justine ; Wetzsteon, Rachel J. ; Strife, C. Frederic ; Leonard, Mary B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c639t-60c5bad08e354f7abb0938a81a237e5d9412638388ca39a7f1c0dc17c41d7bcf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Absorptiometry, Photon</topic><topic>Adolescent</topic><topic>Age</topic><topic>Bone and Bones - diagnostic imaging</topic><topic>Bone Density</topic><topic>Bones</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Chronic illnesses</topic><topic>Chronic kidney failure</topic><topic>Density</topic><topic>Diseases</topic><topic>Female</topic><topic>Fractures</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kidney diseases</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Pediatrics</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Standard scores</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed</topic><topic>Urology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Griffin, Lindsay M.</creatorcontrib><creatorcontrib>Kalkwarf, Heidi J.</creatorcontrib><creatorcontrib>Zemel, Babette S.</creatorcontrib><creatorcontrib>Shults, Justine</creatorcontrib><creatorcontrib>Wetzsteon, Rachel J.</creatorcontrib><creatorcontrib>Strife, C. Frederic</creatorcontrib><creatorcontrib>Leonard, Mary B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Griffin, Lindsay M.</au><au>Kalkwarf, Heidi J.</au><au>Zemel, Babette S.</au><au>Shults, Justine</au><au>Wetzsteon, Rachel J.</au><au>Strife, C. Frederic</au><au>Leonard, Mary B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of dual-energy x-ray absorptiometry measures of bone health in pediatric chronic kidney disease</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>27</volume><issue>7</issue><spage>1139</spage><epage>1148</epage><pages>1139-1148</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background
Dual-energy X-ray absorptiometry (DXA) techniques are limited in childhood chronic kidney disease (CKD) by the confounding effect of short stature and opposing parathyroid hormone effects on trabecular and cortical bone. Peripheral quantitative computed tomography (pQCT) is not subject to these limitations.
Methods
Lumbar spine (LS) and whole-body (WB) DXA and tibia pQCT scans were obtained in 88 stage 4–5 CKD and >650 healthy participants, ages 5–21 years. Sex- and race-specific Z-scores were generated for bone mineral density (BMD) and bone mineral content (BMC) by DXA, relative to age and adjusted for height Z-score (LS-BMD-Z and WB-BMC-Z), and compared to pQCT Z-scores for trabecular BMD (TrabBMD-Z) for age and cortical BMC (CortBMC-Z) for age and tibia length.
Results
LS-BMD-Z [0.50 (95% C.I. 0.28, 0.73),
p
< 0.0001] and TrabBMD-Z [0.53 (0.27, 0.79),
p
< 0.0001] were greater in CKD, and WB-BMC-Z [–0.36 (–0.53, –0.19),
p
< 0.0001] and CortBMC-Z [–0.48 (–0.70, –0.27),
p
< 0.0001] were lower, compared to reference participants. Z-scores were correlated at trabecular (LS-BMD-Z and TrabBMD-Z:
R
= 0.36) and cortical (WB-BMC-Z and CortBMC-Z:
R
= 0.64) sites in CKD; similar to correlations in reference participants.
Conclusions
Lumbar spine and whole-body DXA suggested greater trabecular BMD and lower cortical BMC in CKD, consistent with pQCT results; however, correlations were modest. Studies are needed to identify methods that predict fracture in childhood CKD.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22350304</pmid><doi>10.1007/s00467-012-2116-x</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2012-07, Vol.27 (7), p.1139-1148 |
| issn | 0931-041X 1432-198X |
| language | eng |
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| source | MEDLINE; Springer Online Journals Complete |
| subjects | Absorptiometry, Photon Adolescent Age Bone and Bones - diagnostic imaging Bone Density Bones Child Child, Preschool Children Chronic illnesses Chronic kidney failure Density Diseases Female Fractures Hospitals Humans Kidney diseases Lumbar Vertebrae - diagnostic imaging Male Medicine Medicine & Public Health Nephrology Original Article Pediatrics Renal Insufficiency, Chronic - complications Standard scores Tomography Tomography, X-Ray Computed Urology Young Adult |
| title | Assessment of dual-energy x-ray absorptiometry measures of bone health in pediatric chronic kidney disease |
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