REMS in Nefrology

PAPER OF THE MONTH BY ESCEO

Prestigious recognition from ESCEO for REMS applied to dialysis patients

Finally diagnosis and monitoring are also available to dialysis patients: REMS technology offers new and great opportunities also for this category of fragile patients, overcoming the diagnostic limits of current technologies!

REMS shows all its superiority in diagnostics and monitoring in nephrology: ESCEO chooses the scientific study on the application of REMS in patients affected by Chronic Kidney Disease (CKD) undergoing Peritoneal Dialysis (PD) as Best Scientific Work as the “Paper of The Month” (January 2023) in the international scientific journal ACER (Aging Clinical and Experimental Research).

Chronic Kidney Disease (CKD) is associated with a broad range of bone mineral and endocrine disorders and with an increased risk of fragility fractures.

In terms of fracture risk and bone density changes, Peritoneal Dialysis (PD) has shown less harmful effects than haemodialysis (HD) but it is associated with significant vascular calcifications.

In particular, aortic calcifications (AOC) predispose to an artefactual increase in lumbar spine bone density when measured with the Anterior-Posterior Dual X ray Absorptiometry (AP – DXA) scan.

A possible solution to this problem could be to roll the patient onto their side and switch to a DXA Latero-Lateral scan (DXA LL) – thereby bypassing the aorta and related diagnostic errors. However, this method is not widespread in daily clinical practice as it is a long and laborious examination, therefore, the clinical condition induced by chronic kidney disease is often overlooked due to this important diagnostic limitation.

For these reasons, REMS Technology, being able to automatically discard artifacts, can help overcoming such limitations in fragile populations such as CKD patients.

More in detail, in this study entitled: “Radiofrequency echographic multi spectrometry and DXA for the evaluation of bone mineral density in a peritoneal dialysis setting” by Dr. Angelo Fassio (Fassio A. et. Al. ACER 2022) conducted at the University Hospital of Verona, REMS was compared with DXA in the evaluation of bone density in patients undergoing Peritoneal Dialysis (PD) and the close correlation between DXA LL and REMS in the diagnosis of osteoporosis in CKD patients has been then widely demonstrated.

Furthermore, the data obtained confirmed that the REMS technology is not influenced by the presence of aortic calcifications which are instead responsible for the incorrect overestimation of the BMD obtained using DXA-type techniques.