Pediatr Nephrol. 2010 Jan;25(1):3-5. doi: 10.1007/s00467-009-1248-0. Epub 2009 Jul 15.
Dual x-ray absorptiometry (DXA) is the most widely used densitometric method for diagnosing osteoporosis in adults. It has also been widely adopted as a diagnostic tool in the pediatric population. The most significant limitation of DXA is its reliance on areal rather than volumetric bone mineral density (BMD), which results in an artificial underestimation of bone density in short people. Poor longitudinal growth, however, is an eminent problem in children with chronic kidney disease (CKD). There is also no evidence in children that areal BMD is predictive of future fracture risk, which is the traditional rationale for measuring BMD in children with CKD. Therefore, the Kidney Disease Outcomes Quality Initiative guidelines and the current position of the International Society for Clinical Densitometry (ISCD) on pediatric patients, both of which are presented in this issue of Pediatric Nephrology, do not recommend the use of DXA in children with CKD. To date, there is no consensus on the best method to assess the degree of renal osteodystrophy in this patient population, and further collaborative efforts to correlate densitometric findings with clinical outcomes are warranted.
双能 X 线吸收法（DXA）是目前最广泛用于诊断成年人骨质疏松症的密度测定方法。它也已被广泛应用于儿科人群的诊断工具。DXA 的最大局限性在于它依赖于面积而不是体积骨矿物质密度（BMD），这导致矮个子人群的骨密度被人为低估。然而，慢性肾脏病（CKD）患儿的纵向生长不良是一个突出的问题。也没有证据表明面积 BMD 可以预测未来的骨折风险，这是在 CKD 患儿中测量 BMD 的传统依据。因此，肾脏病结果质量倡议指南和国际临床密度测定学会（ISCD）目前在本期刊上的立场都不建议在 CKD 患儿中使用 DXA。迄今为止，对于该患者人群，评估肾性骨营养不良程度的最佳方法尚无共识，需要进一步合作努力，将密度测定结果与临床结果相关联。
