Ultrasound in Medicine and Biology
Volume 36, Issue 4 , Pages 589-594, April 2010

Quantitative Ultrasound of the Calcaneus in Hemodialysis Patients

  • Chiung-Wen Kuo

      Affiliations

    • Department of Biomedical Engineering and Environmental Sciences, National Tsing-Hua University, Hsinchu, Taiwan, Republic of China
    • Department of Radiological Technology, Yuanpei University, Hsinchu, Taiwan, Republic of China
    • ,
  • Shang-Yun Ho

      Affiliations

    • Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan, Republic of China
    • Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taiwan, Republic of China
    • ,
  • Tung-Hao Chang

      Affiliations

    • Department of Biomedical Engineering and Environmental Sciences, National Tsing-Hua University, Hsinchu, Taiwan, Republic of China
    • Department of Radiation Oncology, Changhua Christian Hospital, Taiwan, Republic of China
    • ,
  • Tieh-Chi Chu

      Affiliations

    • Department of Biomedical Engineering and Environmental Sciences, National Tsing-Hua University, Hsinchu, Taiwan, Republic of China
    • Corresponding Author InformationAddress correspondence to: Tieh-Chi Chu, Department of Biomedical Engineering and Environmental Sciences, National Tsing-Hua University, 101, Section 2 Kuang Fu Road, Hsinchu, Taiwan 300, China, Taiwan.

Received 28 July 2009; received in revised form 24 November 2009; accepted 5 December 2009. published online 08 March 2010.

Abstract 

The aim of this study was to investigate the bone status of hemodialysis patients and identify factors that have influence on bone quality. Four hundred eighty-nine subjects (213 males and 276 females) on maintenance hemodialysis and 696 healthy subjects (309 men, 387 women) were enrolled in this study. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and quantitative ultrasound index (QUI) were assessed by quantitative ultrasound (QUS) at the right calcaneus in both groups. Serum levels of intact parathyroid (iPTH), total alkaline phosphatase (ALP), calcium and phosphate were measured to determine their influence on bone status in hemodialysis patients. All QUS parameters were significantly lower in hemodialysis patients than in controls (p < 0.0001). Stepwise multiple linear regression analysis in male patients indicated that age, weight, calcium-phosphate product and ALP were significant predictors of QUS parameters (adjusted R2 = 0.15 in SOS; adjusted R2 = 0.17 in BUA and QUI). In female patients, same findings including number of parity were observed in SOS only (adjusted R2 = 0.25 in SOS). In postmenopausal patients, the duration of menopause was significant negatively correlated with all QUS parameters (p < 0.01). In conclusion, patients on maintenance hemodialysis had additional risk of bone loss. Advanced age, low body weight, high calcium-phosphate product and high ALP level were important risk factors for deterioration of bone quality. (E-mail: tcchu@mx.nthu.edu.tw)

Key Words: Hemodialysis, Speed of sound, Broadband ultrasound attenuation, Quantitative ultrasound index, Quantitative ultrasound

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PII: S0301-5629(09)01680-9

doi:10.1016/j.ultrasmedbio.2009.12.003

Ultrasound in Medicine and Biology
Volume 36, Issue 4 , Pages 589-594, April 2010

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