| content | ||||||||||||||||||||||||||||||
| Renal osteodystrophy Classification and external resources |
|
| ICD-10 | N25.0 |
|---|---|
| ICD-9 | 588.0 |
| eMedicine | radio/500 |
| MeSH | D012080 |
Renal osteodystrophy is a bone pathology, characterized by defective mineralization, that results from kidney disease. Renal oseodystrophy comes in two different forms, high bone turnover and low bone turnover.
Contents |
Signs and symptoms
Renal osteodystrophy may exhibit no symptoms; if it does show symptoms, they include:
- Bone pain
- Joint pain
- Bone deformation
- Bone fracture
Diagnosis
Renal osteodystrophy is usually diagnosed after treatment for end-stage renal disease begins. Blood tests will indicate decreased calcium and calcitriol and increased phosphate and parathyroid hormone. X-rays will also show bone features of renal osteodystropy (chondrocalcinosis at the knees and pubic symphysis, osteopenia and bone fractures) but may be difficult to differentiate from other conditions.
Pathogenesis
Renal osteodystrophy results from low vitamin D levels, tertiary hyperparathyroidism or hyperphosphatemia, an abnormally elevated serum phosphate, combined with hypocalcaemia, low serum calcium, both of which are due to decreased excretion of phosphate by the damaged kidney.
Differential diagnosis
To confirm diagnosis, renal osteodystrophy must be distinguished from:
- osteoporosis
- osteopenia
- osteomalacia
- hyperparathyroidism
- multiple myeloma
- soft tissue calcification
- chondrocalcinosis
- hypervitaminosis
Treatment
Treatment for renal osteodystrophy includes:
- calcium and vitamin D supplementation
- restrictionof dietary phosphate
- phosphate binders such as calcium carbonate, calcium acetate, sevelamer hydrochloride, or lanthanum carbonate
- cinacalcet
- renal transplantation
- hemodialysis five times a week is thought to be of benefit[1]
Prognosis
Recovery from renal osteodystrophy has been observed post renal transplantation. Renal osteodystrophy is a chronic condition with a conventional hemodialysis schedule.[1]
References
- ^ 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.
External links
- Renal Osteodystrophy - NKUDIC, NIH
|
|||||||||||||||||
