title: Role of osteoclastic dysfunction in the development of renal bone disease.
abstract: A 47-year-old-man was referred for treatment for end-stage renal failure. He had been diagnosed with type II adult onset osteopetrosis before the deterioration of his renal function. He presented with anaemia, severe hypocalcaemia, secondary hyperparathyroidism and azotaemia. An iliac bone biopsy revealed increased bone volume, disturbed osteoid calcification, active osteoclastic bone resorption and fibrous transformation in the bone marrow space. Incomplete osteoclastic dysfunction strongly suggested hypocalcaemia and secondary hyperparathyroidism, and the osteoclastic bone resorption also indicated secondary hyperparathyroidism, even though bone resorption was potentially suppressed. The present case shows that evidence of the involvement of osteoclastic dysfunction in the development of renal bone disease can be found in bone histology.
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Japan. jjkaz@med.niigata-u.ac.jp
authors.forename: Junichiro
authors.initials: J
authors.lastname: James Kazama
authors.forename: Fumitake
authors.initials: F
authors.lastname: Gejyo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurosawa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
mesh_terms: D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology*; D007085:Ilium / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010010:Osteoclasts; D010022:Osteopetrosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging