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Kollagenstoffwechsel und Mineralisation des urämischen Knochens — molekularpathologische Aspekte der renalen Osteodystrophie

Collagen metabolism and mineralization of uremic bone — aspects of the molecular pathology of renal osteodystrophy

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Summary

Important sequelae of uremia are hormonal changes in calcium homeostasis combined with chronic calcium imbalance causing structural alteration and functional insufficiency of bone. Morphological findings of the so called renal osteodystrophy are osteomalacia, osteitis fibrosa and osteoporosis. Osteitis fibrosa and abnormal skeletal metabolism (changes of collagen turnover, insufficient maturation of stable bone crystals) impair the mechanical qualities of bone. Probably the uremia per se influences the collagen metabolism; additional factors such as secondary hyperparathyroidism and deficiency of vitamin D3 are discussed.

Zusammenfassung

Die renale Osteodystrophie reflektiert als chronischer Summationsschaden der Struktur und Funktion des Skeletts komplexe Veränderungen im hormonalen Bereich und der Calciumbilanz. Dem Morphologen zeigt sie sich als Mischbild verschiedener histologischer Befunde, unter denen vor allem die Fibro-Osteoclasie eine fortschreitende Destruktion des Knochens verursacht. Unter dem zusätzlichen Einfluß des gestörten Kollagenstoffwechsels des Knochens und der ungenügenden Bildung druckstabiler Mineralkristalle leiden auch die mechanischen Eigenschaften des Skeletts. Offenbar stört die Urämie per se die Kollagenreifung, als weitere pathogenetische Faktoren werden der Einfluß des sekundären Hyperparathyreoidismus sowie Störungen im Vitamin D3-Metabolismus diskutiert.

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  1. Medizinische Universitätsklinik Würzburg, Germany

    E. Heidbreder, F. Lüke & A. Heidland

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  1. E. Heidbreder
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  2. F. Lüke
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  3. A. Heidland
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Herrn Prof. Dr. med. H.-W. Altmann zum 60. Geburtstag.

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Heidbreder, E., Lüke, F. & Heidland, A. Kollagenstoffwechsel und Mineralisation des urämischen Knochens — molekularpathologische Aspekte der renalen Osteodystrophie. Klin Wochenschr 54, 341–348 (1976). https://doi.org/10.1007/BF01469788

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