Quantitative ultrasound of phalanges of adults with end-stage renal disease or who have undergone renal transplantation.

In patients with end-stage renal disease (ESRD), bone disturbances are common. The aim of this study was to compare the bone mineral status in patients with ESRD, in patients post renal transplantation and in healthy controls. The groups were composed of 218 males and 126 females (ESRD), 43 males and 23 females (renal transplantation) and 614 males and 927 females (healthy controls). Skeletal status was evaluated by quantitative ultrasound measurements of the phalanges using a DBM 1200 (IGEA, Carpi, Italy), which measures the amplitude-dependent speed of sound (Ad-SoS) in m/s. Data analyses were performed with Statistica 6 for Windows (StatSoft, Inc., Tulsa, OK, USA). The Z-scores in gender subgroups were significantly lower in patients undergoing dialysis and after transplantation than in controls (p<0.00001). The Z-scores did not differ between gender subgroups after transplantation and the Z-scores of dialyzed males were significantly better than in females (p<0.00001). The mean value of Z-scores in patients after transplantation was significantly lower than in all patients with ESRD (p<0.05) and in males (p<0.01). The duration of dialysis negatively influenced the Ad-SoS; however, the time elapsed since transplantation did not. The cumulative corticosteroid dose did not correlate with skeletal variables. In conclusion, patients with ESRD treated with hemodialysis and postrenal transplantation patients, across both genders, were observed to have skeletal disturbances.