Study On The Effects Of Bone Scintigraphy In The Diagnosis Of Renal Osteodystrophy

Objective:To understand the imaging status of bone scintigraphy in patients with CKD G5D stage and the relationship with the currently common biomarkers to explore the diagnostic value of bone scintigraphy in ROD.Methods:Twenty three patients undergoing maintenance hemodialysis(MHD)in the Blood Purification Center of Nanchong Central Hospital from December 2018 to December 2019 were selected.General information on the patients(sex,age,dialysis duration)was collected,and venous blood was drawn before dialysis on an empty stomach to detect alkaline phosphatase(ALP),intact parathyroid hormone(iPTH),albumin(ALB),serum creatinine(Cr),blood urea nitrogen(BUN),serum calcium(Ca),serum inorganic phosphorus(P)and other indicators.Bone scintigraphy was performed within one week before or after completing the aforementioned examinations,and regions of interest(ROIs)were set on selected regions in the rear view of the whole body.By setting the ROIs in the thoracic spine,lumbar spine,and right sacroiliac joint,the standarduptake value(SUV)was calculated.Analysis was conducted with Stata 14.0 statistical software,and Pearson correlationanalysiswas performed on SUV,iPTH,P,Ca,dialysisduration,ALP,BUN,Cr,ALB and other indicators.The test standard was 0.05.Results:The primarydiseases in 23 patients with MHD were glomerulonephritis,diabeticnephropathy,benign renal arteriosclerosis,polycystic kidney disease,lupus nephritis,and obstructive nephropathy.The average correction serum calcium concentration was 2.16±0.19(mmol/L),average blood phosphorus concentration 1.79±0.48(mmol/L),average alkaline phosphatase concentration 95.5±38.98(U/L),average concentration of intact parathyroid 555.55±405.97(pg/ml),thoracic spine SUV value 7.46±2.00(g/ml),lumbar spine SUV value 8.63±1.90(g/ml),and right sacroiliac joint SUV value 7.52±3.49(g/ml).Pearson correlation analysis indicated that there was a positive correlation between lumbar SUV and iPTH(r=0.6047,p<0.01),a positive correlation between thoracic SUV and iPTH(r=0.5827,p<0.01),a positive correlation between right sacroiliac SUV and iPTH(r=0.5691,p<0.01),and a positive correlation between blood phosphorus and iPTH(r=0.4826,p<0.05),and there was no significant correlation between dialysis duration and alkaline phosphatase and iPTH.Conclusion:There is a linear positive correlation between iPTH and blood phosphorus in patients with end-stage renal disease,and bone scintigraphy of thoracic spine,lumbar spine,and right sacroiliac joint is significantly related to iPTH.Bone scintigraphy combined with iPTH can provide guidance for determination of the type of bone turnover.