Laowalert S, Khotavivattana T, Wattanachanya L, et al. - In this study among chronic haemodialysis patients (n = 22), researchers focused on the link between bone turnover markers, bone mineral density (BMD), and bone histomorphometry. Findings of bone histomorphometry showed osteitis fibrosa (50%), adynamic bone disease (45%) and mixed uremic osteodystrophy (5%). High bone turnover was predicted by serum intact parathyroid hormone (iPTH) level, with an area under the receiver operating characteristic (ROC) of 0.833. ROC of 0.733 was also yielded by serum TRAP-5b. A sensitivity of 0.917 was reported when high turnover was predicted using serum iPTH (cut-off 484.50 ng/mL) or serum TRAP-5b (cut-off 1.91 pg./mL). A specificity of 1.000 was reported when both iPTH and TRAP-5B were above these cut-offs. In this study, abnormal bone histomorphometry, BMD, and severe vascular calcification were commonly found despite the observation that iPTH levels were close to the target of Kidney Disease Outcomes Quality Initiative guideline. In affording an optimal guide for the treatment, bone biopsy is still essentially needed as a precise diagnostic tool.