Renal osteodystrophy

on 30.8.08 with 0 comments

  • a complex spectrum of abnormalities in patients with chronic renal disease

  • renal disease automatically makes you think problems with vitamin D metabolism, problems with phosphorus, problems with Ca, some problems with alkaline phosphatase. depending on the severity and chronicity as well as treatment of the disease, the patient will manifest with a wide variety of clinical findings

  • so renal osteodystrophy can be very, very complex

  • manifestations can be

    • secondary hyperparathyroidism

    • osteomalacia (see below)

    • some other things not to be covered

Four consequences of renal osteodystrophy, manifest in varying amounts

  • osteoporosis

  • secondary hyperparathyroidism

  • osteosclerosis

  • osteomalacia

Skeletal deformities

  • pediatric

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    • rachitic rosary, which are calcium deposits at the costochondral junctions

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  • adults

    • bone pain

Extraskeletal problems

  • a disturbance in calcium/phosphorus product causes supersaturated extracellular fluid favoring deposition of Ca in soft tissue

  • this is termed dystrophic calcification

End points

  • vessel wall calcification

  • calciphylaxis

  • visceral wall calcification


  • secondary arthritis

  • osteomalacia

  • osteoporosis

Advanced renal osteodystrophy

  • you see osteosclerosis and osteoporosis

  • this results in severe pain and neurological deficits

  • secondary osteroarthritis leads to deformation of bones

Category: Pathology Notes



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