Low-dose CT for assessing microstructural alterations in Renal Osteodystrophy among uremic patients: a retrospective cohort study
Abstract
Background: Renal Osteodystrophy (ROD) is a severe complication among uremic patients. However, the gold standard for diagnosis, bone biopsy, is invasive and difficult to apply routinely. Although low-dose CT (LDCT) is widely used for other assessments in this population, its value in the non-invasive diagnosis of ROD remains to be elucidated.
Purpose: To investigate the feasibility and diagnostic performance of quantitative assessment of lumbar vertebral microstructural changes using routine LDCT images for the identification and diagnosis of ROD and its subtypes.
Methods: This was a retrospective cohort study. A total of 155 uremic patients undergoing regular dialysis who concurrently underwent abdominal/pelvic LDCT and bone metabolic biochemical tests at the Affiliated Hospital of Jinggangshan University between June 2023 and June 2025 were consecutively enrolled. Based on the KDIGO guidelines combined with biochemical markers (iPTH, calcium, phosphorus, ALP, etc.), patients were categorized into a non-ROD group (n = 49), high-turnover ROD (n = 44), low-turnover ROD (n = 30), and mixed-type ROD (n = 32). Using 3D Slicer software, the following parameters were measured in the trabecular bone region of the L1/L2 vertebral bodies: volumetric bone mineral density (vBMD), bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular number (Tb.N), and cortical thickness (Ct.Th). Inter-group differences were compared, correlations between…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 155 participants or records.
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