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Friday, March 25, 2011

RENAL OSTEODYSTROPHY

This metabolic bone disease which accompanies uraemia,
 consists of a mixture of osteomalacia, hyperparathyroid bone disease, osteoporosis and osteosclerosis. Osteomalacia results from failure of the kidney to convert cholecalciferol to its active metabolite 1,25 dihydroxycholecalciferol. A deficiency of the later leads to diminished intestinal absorption of calcium, hypocalcemia and reduction in the calcification of osteiod. Osteitis fibrosa results from secondary hyperparathyroidism, the parathyroid glands being stimulated by the low plasma calcium and possibly also by hyperphosphataemia. In some patients tertiary or autonomous hyperparathyroidism develops. Osteoporosis occurs in many patients possibly related to mild malnutrition. Osteosclerosis is seen mainly in the sacral area; at the base of the skull and in the vertebrae; the cause of this unusual reaction is not known.

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