Bone mineral density and histology in distal renal tubular acidosis Somnuek Domrongkitchaiporn, Chonlatrip Pongsakul, Wasana Stitchantrakul, Vorachai Sirikulchayanonta, Boonsong Ongphiphadhanakul, Piyanuch Radinahamed, Patcharee Karnsombut, Narin Kunkitti, Chatuporn Ruang-Raksa, Rajata Rajatanavin  Kidney International  Volume 59, Issue 3, Pages 1086-1093 (March 2001) DOI: 10.1046/j.1523-1755.2001.0590031086.x Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 1 Transiliac crest bone biopsy from distal renal tubular acidosis (RTA) patients. The bone histology demonstrates a marked reduction in osteoblastic, osteoclastic numbers, and minimal osteoid thickness. The findings are compatible with low turnover bone disease (Masson's trichrome ×150). Kidney International 2001 59, 1086-1093DOI: (10.1046/j.1523-1755.2001.0590031086.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 2 Transiliac crest bone biopsy from one distal RTA patient who developed osteomalacia (patient 1). The bone histology demonstrates a marked reduction in osteoblastic and osteoclastic activities and a marked increase in osteoid thickness (arrows), varying from 15 to 50 μm (Masson's trichrome ×150). Kidney International 2001 59, 1086-1093DOI: (10.1046/j.1523-1755.2001.0590031086.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 3 Relationship between osteoid thickness (μm) and bone formation rate (μm3/μm2/day). There was a marked reduction in bone formation rate in RTA patients. Most patients had normal or minimal elevated osteoid thickness. There was only one patient who had markedly elevated osteoid thickness and justified the diagnosis of osteomalacia. No correlation between osteoid thickness and bone formation rate was found. Kidney International 2001 59, 1086-1093DOI: (10.1046/j.1523-1755.2001.0590031086.x) Copyright © 2001 International Society of Nephrology Terms and Conditions