Renal osteodystrophy.
Renal osteodystrophy is a complex disorder which can be divided into five distinct bone histologic subtypes: mild bone disease, hyperparathyroid bone disease, mixed bone disease, osteomalacia, and low-turnover bone disease. Hyperparathyroidism develops in renal failure due to two principal abnormalities: 1,25(OH)2D3 deficiency and hyperphosphatemia. Treatment of these problems is important in order to prevent hyperparathyroidism. Most cases of osteomalacia, mixed bone disease, and low-turnover bone disease are influenced by aluminum status and parathyroid hormone. Aluminum-associated bone disease can be treated with termination of aluminum exposure and/or deferoxamine therapy. Numerous diagnostic pitfalls exist in the evaluation of renal osteodystrophy, and the bone biopsy is extremely important to avoid these problems and plan proper therapy.
Division of Nephrology and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
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McCarthy
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Kumar
D001847:Bone Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D006801:Humans; D007674:Kidney Diseases / Q000150:complications