[Dynamic scintigraphy with sodium 1-hydroxy-ethane-1,1 diphosphonate for the differential diagnosis of osteomalacia in patients in the terminal stage of chronic kidney failure].

A total of 28 patients were examined. Of them 17 were exposed to systematic hemodialysis, 11 examinees sustained transplantation of the kidney. Dynamic scintigraphy was performed with a computerized gamma-camera. The authors studied the kinetics of the blood discharge of Tc99m-labelled sodium 1-hydroxyethane-1,1 diphosphonate and its accumulation in the osseous tissue. In supine position of the patient a collimator could demonstrate simultaneously pelvic spines, ortal bifurcations and femoral trochanters. Immediately after the administration of the agent the recording was started: 8 frames for the first 2 min, then 38 frames for 38 min by the matrix 64 X 64. Blood REP levels were found by subtraction of the value of its activity in the projection of postero superior pelvic spine from the values in the site of the aortal bifurcation. The authors revealed that in case of osteomalacia the REP blood elimination coefficient (K1) was less than 0.1 min-1 and proposed to use it for distinguishing osteomalacia from other patterns of renal osteodystrophy. Factors that could change the amount of K1 values are discussed.