Abstract
Chronic Kidney Disease (CKD) is commonly associated with alterations in bone and mineral metabolism (renal osteodystrophy). To date, bone biopsy remains the gold standard for the diagnosis and classification of the various types of renal osteodystrophy, namely: osteitis fibrosa, mixed uremic osteodystrophy, osteomalacia, aplastic and adynamic bone disease. However, due to its invasive nature and the fact that it is quite expensive, there has been a clamor for a search for other tests. Traditionally, the level of parathyroid hormone (PTH) has been considered a surrogate of bone turnover. At this time, the search continues for a specific and sensitive biochemical marker for monitoring bone turnover in CKD., e.g., alkaline phosphatase, osteocalcin, collagen degradation products, etc.
In this chapter, we also present the common radiographic findings that are commonly seen in patients with renal osteodystrophy. Other radiographic techniques such as, dual energy x-ray absorptiometry (DEXA) and deferoxamine challenge test (DFO) are also briefly discussed.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Malluche H, Faugere MC. 1990 Renal bone disease: an unmet challenge for the nephrologist. Kidney Int 38:193.
Urena P, Vernejoul M. 1999 Circulating biochemical markers of bone remodeling in uremic patients. Kidney Int 55:2141.
Martin KJ, Olgaard K, Coburn JW et al. 2004 Bone Turnover Work Group: diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy. Am J Kidney Dis 43:558.
Moe SM. 2004 Management of renal osteodystrophy in peritoneal dialysis patients. Perit Dial Int 24:209.
Urena P, Hruby M, Ferreira A et al. 1996 Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. J Am Soc Nephrol 7:506.
Shapiro R. 1972 Radiologic aspects of renal osteodystrophy. Radiol Clin North Am 10:557.
Pluskiewicz W, Adamczyk P et al. 2005 Skeletal status in adolescents with end-stage renal failure: a longitudinal study. Osteoporos Int 16:289.
Eknoyan G, Levin A, Levin NW. 2003 Bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 42:1.
Mazzaferro S, Coen G, Ballanti P et al. 1992 Deferoxamine test and PTH serum levels are useful not to recognize but to exclude aluminum-related bone disease. Nephron 61:151.
Quarles LD. Bone biopsy and the diagnosis of renal osteodystrophy. UptoDate 15.1.
Moe S, Drueke T, Cunningham J et al. 2006 Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 69:1945.
Freemont T. 1999 Histological diagnosis of renal osteodystrophy. Kidney Int 73:S-26.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lerma, E.V. Diagnosis of renal osteodystrophy. Clinic Rev Bone Miner Metab 5, 21–26 (2007). https://doi.org/10.1007/BF02736668
Issue Date:
DOI: https://doi.org/10.1007/BF02736668