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Renal osteodystrophy
Renal osteodystrophy is a bonepathology, 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 a different forms of renal osteodystrophy. Renal osteodystrophy that is characterized by high bone turnover, and renal osteodystrophy that is characterized by low bone turnover.
Inhaltsverzeichnis
- 1 Signs and symptoms
- 2 Diagnosis
- 3 Pathogenesis
- 4 Differential diagnosis
- 5 Treatment
- 6 Prognosis
- 7 References
- 8 External links
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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.
- 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)
- Fractures
Pathogenesis
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 Dlevels and/or tertiary hyperparathyroidism(a dysfunction of the parathyroid gland due to constant stimulation).
Differential diagnosis
- osteoporosis
- osteopenia
- osteomalacia
- hyperparathyroidism
- multiple myeloma
- soft tissue calcification including collagen-vascular disease
- hydroxyapatite crystal deposition disease
- hypervitaminosis
Treatment
- calciumsupplementation
- dietary phosphate restriction
- vitamin D
- phosphate binderscalcium 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.[{{fullurl:Template:FULLPAGENAME}}#endnote_Bonomini]
- renal transplantation
Prognosis
Recovery from renal osteodystrophy has been observed post renal transplantation. Renal osteodystrophy is a chronic(persistent) condition with a conventional hemodialysis schedule.[{{fullurl:Template:FULLPAGENAME}}#endnote_Bonomini]
References
- ^ Bonomini V, Mioli V, Albertazzi A, Scolari P. Daily-dialysis programme: indications and results. Nephrol Dial Transplant. 1998 Nov;13(11):2774-7; discussion 2777-8. PMID 9829478Full Text
- ^ Ibid.
External links
- Osteomalacia and Renal Osteodystrophy- emedicine.com
- Renal Osteodystrophy- NKUDIC, NIH
- Renal osteodystrophy- wrongdiagnosis.com
- Symptoms of renal osteodystrophy
Categories: Organ failure| Nephrology| Medicine stubs
This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Renal+osteodystrophy Wikipedia article Renal osteodystrophy.
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