Background: Adynamic bone disease was initially attributed too aluminum intoxication in association with low circulating levels of parathyroid hormone. More recently adynamic bone disease has been described even in the absence of aluminum intoxication.
Purpose of the study: It was the purpose of this retrospective analysis of 1429 iliac crest biopsies sent to our laboratory from 1985 to 1994 by 41 Italian nephrology and dialysis centres to assess the frequency of adynamic bone disease and aluminum accumulation.
Methods: Adynamic bone disease was diagnosed by histological and histodynamic (tetracycline labelling) analysis, on the basis of predetermined criteria. Aluminum accumulation was assessed by aluminon histochemical staining.
Results: The frequency of adynamic bone disease was fairly constant at approximately 15% from 1985 to 1994. In contrast, aluminum accumulation, defined as positive aluminon histochemical staining, decreased during the same period from 36% to 4%.
Conclusions: Our data clearly show a dissociation of the incidence of adynamic bone disease and aluminium accumulation in bone. At least today, given the low prevalence of aluminium intoxication, factors other than aluminium are the main cause of adynamic bone disease.