Ultrasound Velocity of the Tibia in Patients on Hemodialysis

Abstract

The ultrasound propagation velocity along the cortical of the tibial diaphysis was measured in 42 patients (30 men and 12 women) (age x ± 1 SD: 48.7 ± 18.3 yr; range: 20–86 yr of age) on maintenance hemodialysis and in 185 control subjects matched for age and sex using a SoundScan 2000 equipment. Tibial ultrasound velocity was significantly lower in patients than in age- and sex-matched controls (3698 ± 251 vs 3917 vs 104 m/s; p < 0.001), and even lower in hemodialyzed women than in men, mainly owing to the very low values of postmenopausal women. The mean ± 1 SD of Z-scores values were the following: total population: –2.8 ± 3.8; men: –2.3 ± 3.8; women: –3.2 ± 1.9 (premenopausal women: –1.8 ± 1.4 vs postmenopausal women: –4.1 ± 1.6; p < 0.001). A highly significant negative correlation between ultrasound velocity and iPTH and bone alkaline phosphatase levels was found. There was no correlation between ultrasound velocity and the duration of hemodialysis. In men, unlike women, no correlation was found between ultrasound velocity and age. In summary, tibial ultrasound velocity is lower in patients on hemodialysis than in control subjects, indicating a significant deterioration of cortical bone. This decrease is closely related to the severity of secondary hyperparathyroidism. Tibial ultrasound velocity appears to be a sensitive method to detect these changes.