title: Osteomalacia and insufficiency fracture in a hemodialysis patient with autosomal dominant polycystic kidney disease.
abstract: A 61-year-old Japanese woman on hemodialysis with autosomal dominant polycystic kidney disease (ADPKD) was admitted to the hospital with gluteal pain. Radiographs demonstrated a fracture of the left pubis. The serum 1,25(OH)(2)-vitamin D and 25(OH)-vitamin D levels were low. A biopsy of the right iliac crest disclosed osteomalacia. Active vitamin D sterol was administered in conjunction with dietary modification. Her gluteal pain was resolved three years later, and healing of the fracture was confirmed by radiology. This case emphasizes that vitamin D deficiency and malnutrition can cause osteomalacia in dialysis patients, even if calcium (Ca) and phosphate (P) levels are controlled by calcium carbonate.
authors.affiliation: Nephrology Center, Toranomon Hospital, Japan. rikako64@toranomon.gr.jp
authors.forename: Rikako
authors.initials: R
authors.lastname: Hiramatsu
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suwabe
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sumida
authors.forename: Noriko
authors.initials: N
authors.lastname: Hayami
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamanouchi
authors.forename: Koki
authors.initials: K
authors.lastname: Mise
authors.forename: Eiko
authors.initials: E
authors.lastname: Hasegawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.forename: Kenmei
authors.initials: K
authors.lastname: Takaichi
mesh_terms: D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000209:etiology; D005260:Female; D015775:Fractures, Stress / Q000209:etiology*; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D044342:Malnutrition / Q000150:complications; D008875:Middle Aged; D010018:Osteomalacia / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000628:therapy; D006435:Renal Dialysis; D014808:Vitamin D Deficiency / Q000209:etiology
chemical_list: D006887:Hydroxycholecalciferols; C008088:alfacalcidol