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For the clinical decision of therapy it is most important to differentiate between high and low or adynamic turnover ROD because the therapeutically consequences of these two ends of the ROD spectrum are fundamentally different.<\/jats:p><jats:p>Bone histology remains the gold standard for the exact classification of ROD. Serological markers of bone metabolism are not suited for the accurate nomenclature of ROD but are useful for the sequential follow up of ROD after a clear diagnosis has been made. Similarly, radiological diagnosis of ROD using dual energy X\u2010ray absorptiometry (DEXA) or quantitative computer tomography scan (q\u2010CT) is inaccurate and thus more suited for the routine follow up of established disease.<\/jats:p><jats:p>Besides mineralization, bone strength and the rate of fractures are strongly determined by the architecture of the bone matrix. This information, however, is also only available on bone biopsy sections and cannot be estimated by non\u2010invasive diagnostic methods.<\/jats:p><jats:p>In summary, bone biopsy should be used more liberally for correct classification of bone disease. The sequential follow up and guidance of therapy success can be performed by non\u2010invasive procedures such as biochemical bone marker determination in blood. X\u2010ray imaging and densitometry is suitable only for sequential evaluation of osteoporosis.<\/jats:p>","DOI":"10.1111\/j.1365-2362.2006.01666.x","type":"journal-article","created":{"date-parts":[[2006,7,12]],"date-time":"2006-07-12T07:44:24Z","timestamp":1152690264000},"page":"13-22","source":"Crossref","is-referenced-by-count":29,"title":["Diagnosis of renal 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