Static histomorphometry allows for a diagnosis of bone turnover in renal osteodystrophy in the absence of tetracycline labels

A bone biopsy with prior tetracycline labeling is the gold standard to diagnose renal osteodystrophy. In cases of missing labels, it still paramount gain clinically relevant information from extracted sample, by evaluating static histomorphometry. This study investigates diagnostic performance histomorphometry for evaluation high and low turnover. Transiliac biopsies taken pre- or post- kidney transplantation, sufficient quality a full histomorphometric analysis were included (n = 205). The cohort was randomly split provide separate exploration validation subsets. Diagnostic evaluated area under receiver operator characteristics curve (AUC). All parameters significantly different across categories (24%), normal (60%), (16%) turnover, all significant predictors both turnover (AUC 0.71–0.84). very good as combination resulted in negative positive predictive values (NPV PPV) 80% 96%, respectively. For combined model PPV 71% NPV 82%. We conclude that absence an acceptable alternative diagnosis