Renal osteodystrophy
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2008-05-27T16:33:27Z
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{{Infobox_Disease |
Name = Renal osteodystrophy |
Image = |
Caption = |
DiseasesDB = |
ICD10 = {{ICD10|N|25|0|n|25}} |
ICD9 = {{ICD9|588.0}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = radio |
eMedicineTopic = 500 |
MeshID = D012080 |
}}
'''Renal osteodystrophy''' is a [[bone]] [[pathology]], characterized by defective mineralization, that results from [[Nephrology|kidney disease]]. Renal oseodystrophy comes in two different forms, high bone turnover and low bone turnover.
==Signs and symptoms==
Renal osteodystrophy may exhibit no symptoms; if it does show symptoms, they include:
*[[Bone pain]]
*[[Arthralgia|Joint pain]]
*Bone deformation
*[[Bone fracture]]
==Diagnosis==
Renal osteodystrophy is usually diagnosed after treatment for [[Chronic kidney diseaase|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<ref name=bonomini>{{cite journal |author=Bonomini V, Mioli V, Albertazzi A, Scolari P |title=Daily-dialysis programme: indications and results |journal=Nephrol. Dial. Transplant. |volume=13 |issue=11 |pages=2774–7; discussion 2777–8 |year=1998 |pmid=9829478 |doi=}}</ref>
==Prognosis==
Recovery from renal osteodystrophy has been observed post renal transplantation. Renal osteodystrophy is a [[chronic (medicine)|chronic]] condition with a conventional hemodialysis schedule.<ref name=bonomini/>
==References==
{{reflist}}
==External links==
*[http://kidney.niddk.nih.gov/kudiseases/pubs/renalosteodystrophy/ Renal Osteodystrophy] - NKUDIC, NIH
{{Nephrology}}
[[Category:Organ failure]]
[[Category:Kidney diseases]]
[[Category:Histopathology]]
[[de:Renale Osteodystrophie]]
[[fr:Ostéodystrophie rénale]]