[Kidney and bone update : the 5-year history and future of CKD-MBD. Bone biopsy and histomorphometrical analysis].

In the KDIGO CKD-MBD guideline, the disorder "renal osteodystrophy" is defined as bone histological changes, which can be diagnosed only by bone biopsy. New bone diagnosis method, "TMV classification" is introduced instead of classical classification system. In order to diagnose TMV classification, undecalcified bone specimen after tetracycline double labeling is required. In TMV classification, "T" stands for bone turnover and is evaluated by bone formation rate (BFR/BS) or activation frequency (Acf) . "M" stands for bone mineralization and is evaluated by mean osteoid thickness (O.Th) and mineralization lag time (Mlt) . "V" stands for cancellous bone volume and is diagnosed by total bone volume (BV/TV) .