Abstract: FR-PO0248
Bone Health Monitoring in CKD and Kidney Transplant Patients with Radiofrequency Echographic Multispectrometry (REMS)
Session Information
- Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Di Paola, Marco, Institute of Clinical Physiology, National Research Council, Lecce, Apulia, Italy
- Conversano, Francesco, Institute of Clinical Physiology, National Research Council, Lecce, Apulia, Italy
- Del Vecchio, Gianmarco, Research and Development, Echolight S.p.a., Lecce, Apulia, Italy
- Lombardi, Fiorella Anna, Institute of Clinical Physiology, National Research Council, Lecce, Apulia, Italy
- MacLaughlin, Edmund J, Rheumatology Associates of Delmarva, Easton, Maryland, United States
- Methric, Kathleen, BoneVue Diagnostics, Catonsville, Maryland, United States
- Muratore, Maurizio, ASL-LE, Leccee, Apulia, Italy
- Peluso, Giusy, Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Apulia, Italy
- Pisani, Paola, Institute of Clinical Physiology, National Research Council, Lecce, Apulia, Italy
- Casciaro, Sergio, Institute of Clinical Physiology, National Research Council, Lecce, Apulia, Italy
Background
CKD is common and serious condition. Kidney failure, the end stage, needs dialysis or transplant for survival. CKD alters mineral/bone metabolism and kidney transplant can help, but does not fully restore bone health; patients remain 2–3 times more fracture-prone, partly due to post-transplant corticosteroids. DXA is often used but can underestimate bone health due to artifacts. This study assesses Radiofrequency Echographic Multi-Spectrometry (REMS), a radiation-free, artifact-excluding tool, in two CKD cohorts, including transplant recipients.
Methods
REMS compares raw, backscattered signals to a proprietary reference database to extract both quantitative (BMD, T- and Z-score) and qualitative (bone microarchitecture via Fragility Score) data. By combining these two parameters, the system automatically develops a progressive classification system consisting of 7 risk levels (R1-R7), each associated with the probability of imminent 5-years Fracture Risk (FR).
Results
A cohort of 88 Caucasian patients (both genders, mean age: 61 years) with CKD (n = 22) and post-transplant CKD (n = 66) underwent REMS scans at femoral neck. Both groups were classified as severe osteopenic, with a lower T-score mean (-2.2 ± 0.8) in transplant recipients compared to CKD patients (-2.0 ± 0.7). In FR analysis. ~80% of transplant recipients was classified in high-risk classes: R4 (37.9%), R5 (9.1%), and R6 (33.3%), which correspond to up to a 5% probability of hip fractures. Conversely, 77.3% of CKD patients were in moderate-/high-risk classes: 45.5% (R3), 31.8% (R4) and 22.8% (R6).
Conclusion
CKD contributes to progressive deterioration of BMD. Kidney transplant, often considered as a necessary therapeutic strategy, does not mitigate the risk of skeletal complications, but leads to an increase, which may affect quality-life and long-term management. Thanks to its advantages and capability to measure bone quality and quantity, REMS technology demonstrates strong potential as a reliable tool for early intervention and continuous monitoring, overcoming major limitations of current methodologies.
*All authors are equal contributors.