Assesment of Bone Strength Using a New Quantitative Ultrasound Device in Chidren with Renal Diseases

ABSTRACT

PURPOSE: Metabolic bone diseases have been major problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. METHODS: Forty-four children with renal diseases who were diagnosed at the pediatric nephrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. RESULTS: A total of 44 patients were evaluated. The age at initial diagnosis was 6.7+/-4.2 years. At the time of evaluation, the chronological and bone age was 9.3+/-4.2 years and 8.2+/-4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. CONCLUSION: The prevalence of osteoporosis was 12% in 44 children with renal diseases. No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.