Definition:
Renal osteodystrophy is described as a bone pathology marked by defective mineralization as a consequence of kidney disease. Renal oseodystrophy has two distinct forms, namely high bone turnover and low bone turnover.
Diagnosis:
Renal osteodystrophy is often detected at the beginning of treatment for end-stage renal disease. Blood tests will show decreased levels of calcium and calcitriol, and increased levels of parathyroid hormone and phosphate. X-rays will reveal bone features of renal osteodystropy (chondrocalcinosis at the knees and pubic symphysis, osteopenia and bone fractures).
Treatment:
Initial treatment for renal osteodystrophy includes supplementing the patient's calcium and vitamin D and restricting the patient's dietary phosphate. Cinacalcet and phosphate binders such as calcium acetate, lanthanum carbonate, calcium carbonate, and sevelamer hydrochloride may also be prescribed. In severe cases, renal transplantation and constant hemodialysis may be necessitated.
Symptoms and Signs:
Renal osteodystrophy may be mostly asymptomatic. When the condition does exhibit symptoms, the most common signs are pain in the bones and joints, bone fracture, and bone deformation.
Causes:
Renal osteodystrophy develops as a result of abnormally low levels of vitamin D in the body, extremely high levels of serum phosphate, tertiary hyperparathyroidism or hyperphosphatemia, as well as hypocalcaemia and low serum calcium levels. The latter two are attributed to the decreased excretion of phosphate by a damaged kidney.
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