The prevalence of bone aluminum deposition in renal osteodystrophy and its relation to the response to calcitriol therapy.
The prevalence of bone aluminum deposition in renal osteodystrophy and its relation to the response to calcitriol therapy.
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肾性骨营养不良中骨铝沉积的患病率及其与骨化三醇治疗反应的关系。
DOI：
10.1056/nejm198209163071202
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
Sherrard,DJ
中科院分区：
文献类型：
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作者：
Ott,SM;Maloney,NA;Coburn,JW;Alfrey,AC;Sherrard,DJ
骨铝的组织化学染色使我们能够确定铝在肾性骨营养不良中的患病率和染色特征。染色方法与 96 个样品的原子吸收研究结果具有良好的相关性（r = 0.81；P<0.001）。我们检查了 315 个骨活检样本。在对照组或患有非肾性骨疾病的患者中未发现铝。在肾性骨营养不良中，骨软化病变中可染色铝的平均水平（每平方毫米组织面积1.12±0.09毫米）显着高于轻度、混合或纤维化病变（分别为每平方毫米0.43±0.06、0.34±0.11和0.10±0.03毫米；P<0.001）。百分之七十的骨软化样品有严重的铝染色。通过双四环素标记测量，在铝含量高的样品中，89% 的骨附着率较低。对骨化三醇有临床反应的患者的可染色骨铝平均水平显着低于无反应的患者（0.13±0.4 vs. 1.06±0.9 mm/mm2；P<0.01）。我们得出结论，铝沉积与骨形成或矿化受损以及对骨化三醇治疗的不良反应有关。 （新英格兰医学杂志，1982 年；307：709–13。）
A histochemical stain for bone aluminum allowed us to determine the prevalence and staining characteristics of aluminum in renal osteodystrophy. The staining method correlated well with the results of atomic-absorption studies in 96 samples (r = 0.81; P<0.001). We examined 315 bone-biopsy samples. No aluminum was seen in controls or patients with nonrenal bone diseases. In renal osteodystrophy, the mean level of stainable aluminum was significantly higher in osteomalacic lesions (1.12±0.09 mm per square millimeter of tissue area) than in mild, mixed, or fibrotic lesions (0.43±0.06, 0.34±0.11, and 0.10±0.03 mm per square millimeter, respectively; P<0.001). Seventy per cent of osteomalacic samples had heavy aluminum staining. The bone-apposition rate, measured by double tetracycline labels, was low in 89 per cent of the samples with high levels of aluminum. The mean level of stainable bone aluminum in patients who had a clinical response to calcitriol was significantly lower than in those who did not respond (0.13±0.4 vs. 1.06 ±0.9 mm per square millimeter; P<0.01).We conclude that aluminum deposition is associated with impaired bone formation or mineralization and with a poor response to calcitriol therapy. (N Engl J Med. 1982; 307:709–13.)