Renal bone disease

Curr Opin Endocrinol Diabetes Obes. 2010 Dec;17(6):535-9. doi: 10.1097/MED.0b013e3283400945.

Abstract

Purpose of review: Renal osteodystrophy is a complex disorder of bone associated with chronic kidney disease (CKD). Disturbances in mineral metabolism, which include, phosphate retention, hypocalcemia, vitamin D deficiency, and hyperparathyroidism develop early in the progression of CKD. The Kidney Disease: Improving Global Outcomes (KDIGO) has proposed a new classification system to understand the complex pathophysiology in mineral metabolism and bone disease. Understanding this pathophysiology has become especially important, as recent evidence has suggested that disordered mineral metabolism is associated with increased cardiovascular mortality and morbidity in patients with CKD.

Recent findings: This review discusses the effect of these disturbances on the skeleton and how they result in altered bone structure and turnover. The degree of hyperparathyroidism appears to affect bone turnover; however, bone biopsies appear to be the only definitive method to specifically diagnose the bone lesion.

Summary: This review will assist the clinician in the early identification of patients at risk of renal osteodystrophy. Therapeutic strategies could then be employed to prevent and correct these disturbances in mineral metabolism and, thus, avoid patient morbidity.

Publication types

  • Review

MeSH terms

  • Bone and Bones / pathology
  • Bone and Bones / physiopathology
  • Chronic Kidney Disease-Mineral and Bone Disorder* / diagnosis
  • Chronic Kidney Disease-Mineral and Bone Disorder* / epidemiology
  • Chronic Kidney Disease-Mineral and Bone Disorder* / physiopathology
  • Chronic Kidney Disease-Mineral and Bone Disorder* / therapy
  • Disease Progression
  • Early Diagnosis
  • Humans
  • Hyperparathyroidism, Secondary / etiology
  • Hyperparathyroidism, Secondary / prevention & control
  • Kidney / physiopathology
  • Parathyroid Hormone / blood

Substances

  • Parathyroid Hormone