Thirteen patients treated with
CAPD, 22 patients maintained on
hemodialysis (HD) using
aluminium-free water and matched for
duration of treatment and 15 conservatively treated uremic patients (CONS) were evaluated by iliac bone biopsy to analyse the influence of
CAPD on bone histomorphometry.
CAPD patients were significantly (p less than 0.05) older (63.1 +/- 14.0, HD 52.7 +/- 13.3, CONS 53.3 +/- 11.7). Compared to HD the results were as follows:
CAPD patients required significantly less
aluminium to control
hyperphosphatemia (0.16 vs. 0.49 g, p less than 0.005). They had a significantly lower incidence of symptomatic
bone disease (p less than 0.05). Histomorphometry showed significantly lower osteoid volume (4.3 + 2.8% vs. 8.6 + 5.5%, p less than 0.05) and
aluminium labelling intensity (0.15 vs. 1.0, p less than 0.05). Apart from bone mass indices, other histomorphometric variables showed an insignificantly more favourable trend in
CAPD patients compared to HD. CONS patients had a significantly lower bone formation rate than
CAPD (p less than 0.05), but otherwise no histomorphometric differences were observed. We conclude that
CAPD patients require less
aluminium therapy, have a lower risk of
aluminium bone contamination, and may have a lower risk of developing uremic osteodystrophy.