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Renal Osteodystrophy: Pathogenesis, Prevention and Treatment

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Pediatric Nephrology

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Abstract

Renal osteodystrophy is a complex disorder expressing at the musculoskeletal level the metabolic abnormalities of renal disease (1). It is universally present in patients with chronic renal disease and continues to be one of the more difficult problems that confront the clinician charged with the responsibility of managing patients with chronic renal failure. A major difficulty in attempting to adopt a rational approach in these patients’ management has been the lack of a complete understanding of the pathogenesis of the deranged skeletal metabolism (2,3). Recently, development of morphometric analysis of bone biopsies, sensitive assays of vitamin D metabolites and parathormone (PTH), specific vitamin D metabolites for experimentation combined with formulation of testable hypotheses, have expanded our understanding of calcium and phosphorus homeostasis in renal osteodystrophy. New therapeutic trends, based on recent pathophysiologic information, can be perceived which have already changed the often dramatic clinical picture seen 10–15 years ago. Treatment of renal osteodystrophy undoubtedly will undergo much refinement within the next five years and its prevention appears as a reachable goal.

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  1. Div. Nephrol., Dept. Med., Univ. Miami Sch. Med., Miami, Fla., 33101, USA

    Jacques J. Bourgoignie M.D.

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  1. Jacques J. Bourgoignie M.D.
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  1. University of Miami School of Medicine, Miami, Florida, USA

    José Strauss

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Bourgoignie, J.J. (1981). Renal Osteodystrophy: Pathogenesis, Prevention and Treatment. In: Strauss, J. (eds) Pediatric Nephrology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-8804-3_31

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  • DOI: https://doi.org/10.1007/978-1-4684-8804-3_31

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