Chesney R W, Mazess R B, Rose P G, Jax D K
Pediatrics. 1977 Dec;60(6):864-72.
Bone width (BW), bone mineral content (BMC), and their ration (BMC/BW ratio) were measured in renal patients using direct photon absorptiometry. Serial measurements were made on the radius and ulna in 74 children with renal diseases. Values were compared to age-, sex-, height-, and weight-matched controls. The SD from the mean in normal subjects is +/- 10%. Significant demineralization (greater than -2 SD) was found in 42% of all patients and in 75% with tubulointerstitial disease. Twelve patients with nephrotic syndrome and two with systemic lupus erythematosus, all of whom were receiving prednisone therapy and had a serum creatinine level less than 1.0 mg/dl, and three treated with anticonvulsants had significant demineralization. Severe demineralization (greater than -3 SD) was found in four rachitic patients with tubulointerstitial disease. Normal mineralization was present in 32 patients with various primary glomerular diseases, seven of whom had a serum creatinine level greater than 1.5 mg/dl. BMC declined with daily prednisone therapy but increased with alternate-day dosage in seven patients. This study suggests that demineralization is more common in patients with tubulointerstitial disease and in patients with primary glomerular disease who are receiving prednisone (16 patients) or anticonvulsants. Photon absorptiometry appeared more useful than conventional radiographic evaluation in assessing skeletal involvement in childhood renal disease.
采用直接光子吸收法对肾病患者的骨宽度（BW）、骨矿物质含量（BMC）及其比值（BMC/BW比值）进行了测量。对74例肾病患儿的桡骨和尺骨进行了系列测量。将测量值与年龄、性别、身高和体重匹配的对照组进行比较。正常受试者的平均值标准差为±10%。在所有患者中，42%存在明显的骨质减少（大于-2个标准差），在肾小管间质性疾病患者中这一比例为75%。12例肾病综合征患者和2例系统性红斑狼疮患者均接受泼尼松治疗且血清肌酐水平低于1.0mg/dl，还有3例接受抗惊厥药物治疗的患者存在明显的骨质减少。4例患有肾小管间质性疾病的佝偻病患者出现严重骨质减少（大于-3个标准差）。32例各种原发性肾小球疾病患者的矿化正常，其中7例血清肌酐水平大于1.5mg/dl。7例患者的BMC随每日泼尼松治疗而下降，但随隔日给药而升高。本研究表明，骨质减少在肾小管间质性疾病患者以及接受泼尼松治疗（16例患者）或抗惊厥药物治疗的原发性肾小球疾病患者中更为常见。在评估儿童肾病的骨骼受累情况时，光子吸收法似乎比传统的放射学评估更有用。
