Renal osteodystrophy is a bone pathology, characterized by defective mineralization, that results from renal disease. renal - refers to kidney, osteo - refers to bone, and dystrophy - means degenerative disorder (like dystrophy in muscular dystrophy). more...
There are a different forms of renal osteodystrophy. Renal osteodystrophy that is charachterized by high bone turnovver and renal osteodystrophy that is charachterozed by low bone turover
Signs and symptoms
- Silent (no symptoms).
- Bone pain.
- Joint pain.
- Bone deformation.
Usually diagnosed after treatment for end-stage renal disease (ESRD) begins.
- Blood tests - calcium (is decreased), phosphate (is elevated), calcitriol (vitamin D) (is decreased), PTH (is elevated).
- Bone biopsy (bone has abnormal structure).
Can be recognized on X-ray (but may be difficult to differentiate from other conditions). Features on X-ray:
- Calcification of cartilage (chondrocalcinosis) - typically at the knees and pubic symphysis.
- Bone loss - "patchy" appearance (osteopenia)
Renal osteodystrophy results from an abnormally elevated serum phosphate (hyperphosphatemia) and low serum calcium (hypocalcemia), both of which are due to decreased excretion/no excretion of phosphate by the damaged kidney, low vitamin D levels and/or tertiary hyperparathyroidism (a dysfunction of the parathyroid gland due to constant stimulation).
- multiple myeloma
- soft tissue calcification including collagen-vascular disease
- hydroxyapatite crystal deposition disease
- calcium supplementation
- dietary phosphate restriction
- vitamin D
- phosphate binders calcium carbonate (Tums), calcium acetate (PhosLo), sevelamer hydrochloride (Renagel), or lanthanum carbonate (Fosrenol)
- cinacalcet - a calcimimetic
- frequent hemodialysis (five times a week) is thought to be of benefit.
- renal transplantation
Recovery from renal osteodystrophy has been observed post renal transplantation. Renal osteodystrophy is a chronic (persistent) condition with a conventional hemodialysis schedule.
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