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Renal osteodystrophy



Renal osteodystrophy
Classification & external resources
ICD-10 N25.0
ICD-9 588.0
eMedicine radio/500 

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).

There are different forms of renal osteodystrophy. Renal osteodystrophy that is characterized by high bone turnover, and renal osteodystrophy that is characterized by low bone turnover.

Additional recommended knowledge

Contents

Signs and symptoms

  • Silent (no symptoms).
  • Bone pain.
  • Joint pain.
  • Bone deformation.
  • Fractures.

Diagnosis

Usually diagnosed after treatment for end-stage renal disease (ESRD) begins.


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)
  • Fractures

Pathogenesis

The mineral content of bone is calcium hydroxyapatite, Ca5(PO4)3(OH). When calcium is being actively resorbed from bone, the phosphate also enters the blood stream. The kidney is the primary means of excreting excess phosphate. Renal osteodystrophy results from an abnormally elevated serum phosphate (hyperphosphatemia) and low serum calcium (hypocalcemia), both of which are due to decreased excretion of phosphate by the damaged kidney, low vitamin D levels or tertiary hyperparathyroidism (a dysfunction of the parathyroid gland due to constant stimulation).

Differential diagnosis

Treatment

Prognosis

Recovery from renal osteodystrophy has been observed post renal transplantation. Renal osteodystrophy is a chronic (persistent) condition with a conventional hemodialysis schedule.[1]

References

  1. ^ a b Bonomini V, Mioli V, Albertazzi A, Scolari P (1998). "Daily-dialysis programme: indications and results". Nephrol. Dial. Transplant. 13 (11): 2774-7; discussion 2777-8. PMID 9829478.
 
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Renal_osteodystrophy". A list of authors is available in Wikipedia.
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