Renal osteodystrophy

Renal osteodystrophy
Other namesRenal rickets
SpecialtyNephrology, orthopedic surgery Edit this on Wikidata

Renal osteodystrophy is currently defined as an alteration of bone morphology in patients with chronic kidney disease (CKD).[1] It is one measure of the skeletal component of the systemic disorder of chronic kidney disease-mineral and bone disorder (CKD-MBD).[1][2][3] The term "renal osteodystrophy" was coined in 1943,[4] 60 years after an association was identified between bone disease and kidney failure.[5]

The traditional types of renal osteodystrophy[6] have been defined on the basis of turnover and mineralization as follows: 1) mild, slight increase in turnover and normal mineralization; 2) osteitis fibrosa, increased turnover and normal mineralization; 3) osteomalacia, decreased turnover and abnormal mineralization; 4) adynamic, decreased turnover and acellularity; and, 5) mixed, increased turnover with abnormal mineralization.[1] A Kidney Disease: Improving Global Outcomes report has suggested that bone biopsies in patients with CKD should be characterized by determining bone turnover, mineralization, and volume (TMV system).[2]

On the other hand, CKD-MBD is defined as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of the following: 1) abnormalities of calcium, phosphorus, PTH, or vitamin D metabolism; 2) abnormalities in bone turnover, mineralization, volume, linear growth, or strength (renal osteodystrophy); and 3) vascular or other soft-tissue calcification.[1][7]

  1. ^ a b c d Eckardt, Kai-Uwe; Kasiske, Bertram L. (August 2009). "KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)" (PDF). Kidney International Supplements. 76 (113). Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group: S1–130. doi:10.1038/ki.2009.188. PMID 19644521.
  2. ^ a b Moe S, Drüeke T, Cunningham J, Goodman W, Martin K, Olgaard K, Ott S, Sprague S, Lameire N, Eknoyan G (June 2006). "Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO)". Kidney International. 69 (11): 1945–53. doi:10.1038/sj.ki.5000414. PMID 16641930.
  3. ^ "ERA-EDTA Working Group on Chronic Kidney Disease and Mineral Bone Disorder (CKD-MBD)". Retrieved 4 February 2016.
  4. ^ Lui S, Chu H (1943). "Studies in calcium and phosphorus metabolism with special reference to pathogenesis and effects of dihydrotachysterol (A.T.10) and iron". Medicine. 22 (2): 103–107. doi:10.1097/00005792-194305000-00002.
  5. ^ Lucas RC (1833). "Form of late rickets associated with albuminuria, rickets of adolescents". The Lancet. 1 (3119): 993–994. doi:10.1016/S0140-6736(02)37965-0.
  6. ^ Llach F, Bover J (2000). "Renal Osteodystrophies". In Brenner BM (ed.). The Kidney. Philadelphia: W.B. Saunders Company. pp. 2103–2186. ISBN 978-0-7216-7998-3.
  7. ^ Cozzolino M, Ureña-Torres P, Vervloet MG, Brandenburg V, Bover J, Goldsmith D, Larsson TE, Massy ZA, Mazzaferro S (October 2014). "Is chronic kidney disease-mineral bone disorder (CKD-MBD) really a syndrome?" (PDF). Nephrology, Dialysis, Transplantation. 29 (10): 1815–20. doi:10.1093/ndt/gft514. PMID 24516228.