Renal osteodystrophy

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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 1 Signs and symptoms 2 Diagnosis 3 Pathogenesis 4 Differential diagnosis 5 Treatment 6 Prognosis 7 References 8 External links

[edit] Signs and symptoms

Renal osteodystrophy may exhibit no symptoms; if it does show symptoms, they include:

• Bone pain
• Joint pain
• Bone deformation
• Bone fracture

[edit] 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.

[edit] 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.

[edit] Differential diagnosis

To confirm diagnosis, renal osteodystrophy must be distinguished from:

• osteoporosis
• osteopenia
• osteomalacia
• hyperparathyroidism
• multiple myeloma
• soft tissue calcification
• chondrocalcinosis
• hypervitaminosis

[edit] 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]

[edit] Prognosis

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

[edit] References

[edit] External links

• Renal Osteodystrophy - NKUDIC, NIH

v • d • e Urinary system - Pathology - Nephrology, including nephritis and nephropathy (N00-N39, 580-599) Diseases of the glomerulus Glomerulonephritis - Focal segmental glomerulosclerosis - Membranoproliferative glomerulonephritis - Membranous glomerulonephritis - Nephritic syndrome - Post-streptococcal glomerulonephritis - Nephrotic syndrome (Minimal change disease) - IgA nephropathy - Lupus nephritis - Diabetic nephropathy - Rapidly progressive glomerulonephritis Tubulointerstitial diseases of the kidney Interstitial nephritis - Pyelonephritis - Hydronephrosis - Pyonephrosis - Balkan nephropathy - Reflux nephropathy Renal failure Acute renal failure (Acute tubular necrosis) - Chronic renal failure Urolithiasis Kidney stone - Renal colic Diseases of the renal tubule and other disorders of kidney and ureter Renal osteodystrophy - Nephrogenic diabetes insipidus - Nephroptosis - Ureterocele - Abderhalden-Kaufmann-Lignac syndrome - Inborn errors of renal tubular transport (Renal tubular acidosis, Gitelman syndrome) Other diseases and disorders of urinary system urinary bladder: Cystitis (Interstitial cystitis, Trigonitis) - Neurogenic bladder - Vesicointestinal fistula urethra: Urethritis (Non-gonococcal urethritis) - Urethral syndrome - Urethral stricture Urinary tract infection Tumors of the kidney Renal cell carcinoma - Wilms' tumor (children) See also congenital conditions (Q60-Q64, 753)