Diagnostic agreement of bone histomorphometry for renal bone disease

Article Article scientifique Article Diagnostic agreement of bone histomorphometry for renal bone disease eng 2026-04-08 author Jørgensen Hanne Skou Department of Clinical Medicine, Aarhus University, Aarhus, Denmark and Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark. author Ystrøm Ina Karstoft Department of Clinical Medicine, Aarhus University, Aarhus, Denmark and Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark. author Maes Christa Laboratory of Skeletal Cell Biology and Physiology (SCEBP), Skeletal Biology and Engineering Research Center (SBE), Department of Development and Regeneration, KU Leuven, Leuven, Belgium. author Nefyodova Elena Laboratory of Skeletal Cell Biology and Physiology (SCEBP), Skeletal Biology and Engineering Research Center (SBE), Department of Development and Regeneration, KU Leuven, Leuven, Belgium. author Kröger Heikki Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland; Department of Orthopedics, Traumatology, and Hand Surgery, Kuopio University Hospital, Finland. author Tong XiaoYu Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland. author Ferreira Anibal Nova Medical School, Lisbon, Portugal and Department of Nephrology, ULS São José, Hospital Curry Cabral, Lisbon, Portugal. author Ferreira Ana Carina Nova Medical School, Lisbon, Portugal and Department of Nephrology, ULS São José, Hospital Curry Cabral, Lisbon, Portugal. author Poole Kenneth NIHR Cambridge Biomedical Research Centre and Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. author Skingle Linda NIHR Cambridge Biomedical Research Centre and Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. author Tabegna Fabiana Gouveia Alves NIHR Cambridge Biomedical Research Centre and Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. author Gerbaix Maude Coline Faculty of Medicine, Geneva, Switzerland and Service of Bone Diseases, Department of Medicine, Geneva University Hospitals, Switzerland. 790754 Département de médecine (DEMED) author Trombetti Andrea 0000-0002-0540-7024 Faculty of Medicine, Geneva, Switzerland and Service of Bone Diseases, Department of Medicine, Geneva University Hospitals, Switzerland. 582321 Département de médecine (DEMED) author Lafage-Proust Marie-Hélène 416961 Département de médecine (DEMED) author Evenepoel Pieter Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, Katholieke Universiteit Leuven, Leuven, Belgium and Department of Medicine, Division of Nephrology, University Hospitals Leuven, Leuven, Belgium. author Bravenboer Nathalie Department of Laboratory Science, Amsterdam University Medical Centers Amsterdam, the Netherlands and Amsterdam Movement Sciences Research Institute, Tissue Function and Regeneration, Amsterdam, the Netherlands. Electronic address: n.bravenboer@amsterdamumc.nl. European Renal Osteodystrophy initiative of the CKD-MBD working group of the European Renal Association 117887 10.1016/j.bone.2026.117887 41962786 1873-2763 https://www.sciencedirect.com/science/article/pii/S8756328226001134 Introduction: An iliac bone biopsy with semi-quantitative histomorphometry is the gold standard for evaluating renal osteodystrophy (ROD). However, lack of standardization of the bone biopsy procedure, sample handling, reading and reporting represent barriers to research synthesis and clinical collaboration. This study assessed diagnostic agreement across European laboratories performing histomorphometry for evaluation of ROD. Methods: Five-millimeter transiliac biopsy slides from 5 cases were converted to digital images for analysis by experts from 7 laboratories. Parameters included quantitative histomorphometry, bone turnover, mineralization and volume (TMV) classification, and a concluding diagnosis. Agreement was analysed using Kappa statistics for categorical and intraclass correlation coefficients (ICC) for continuous variables. Results: Agreement on histomorphometric variables ranged from poor to excellent. High agreement was observed for the static parameters bone area (ICC 0.91), osteoid area (ICC 0.95) and osteoid perimeter (ICC 0.84). For dynamic parameters, agreement was high for mineralizing surface (ICC 0.87) and bone formation rate (ICC 0.74), but poor for mineral apposition rate (ICC -0.13) and mineralization lag time (ICC 0.07). Agreement on the TMV classification was substantial for bone turnover (Kappa 0.77), slight for bone mineralization (Kappa 0.14), and substantial for bone volume (Kappa 0.73). The concluding diagnoses showed a high degree of consistency. Conclusions: Despite considerable inter-reader variability in bone histomorphometric measures, the clinical diagnoses of ROD were consistent across laboratories. Key sources of variability included analytical methods, disagreement on reference values, and differences in the definition of mineralization disorder. Further work should be undertaken to reach consensus on these points. Chronic kidney disease Chronic kidney disease – mineral and bone disorder Cross-validation Histomorphometry Human Osteoporosis Renal osteodystrophies Dewey 616 56 Département de médecine 221 false 289 Métabolisme osseux 544 Bone 208 dc1a29e1-38fa-429f-a13c-0bbfdfd3976c Article (Published version) Public Diagnostic_agreement_of_bone_histom.pdf 1268442 application/pdf CC BY-4.0 5da1a938399801c7265c61c081e541029537076af0c8d5ad0f9270c4216eea34 openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

Title	Published in	Access level	OA Policy	Year	Views	Downloads

Diagnostic agreement of bone histomorphometry for renal bone disease	Bone			2026	10	86

Archive ouverte UNIGE

Lafage-Proust, Marie-Hélène