Fact-sheet: Renal osteodystrophy


Updated on 09/17/2021 at 12:16 PM

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Definition

Osteopathy in patients with chronic renal failure.
Variable combination of 2 types of bone structure abnormalities:
-OSTEITIS FIBROSA: rapid bone turnover, increased PTH: secondary hyperparathyroidism
-OSTEOMALACIA: slow bone turnover: normal or decreased PTH: no secondary hyperparathyroidism

Clinical features

variable:
– Diffuse bone pain
– Muscle fatigability (proximal myopathy)
– severe pruritus (subcutaneous precipitation of calcium phosphate)
– Growth retardation
– Skeletal deformities
– dental abnormalities
-Tumoral calcinosis

Laboratory findings

Renal failure manifests as:
– decreased creatinine clearance
– normal or decreased calcemia
– hyperphosphatemia
– elevated serum alkaline phosphatase
– pancytopenia in severe forms of osteitis fibrosa

Radiography

OSTEOSCLEROSIS:
More common than in primary hyperparathyroidism
• often multifocal: gives the bone a mottled appearance
• 20% of patients
• classic in the axial skeleton:
rugger jersey spine
• may also affect the appendicular skeleton: metaphyses