Document Detail


The clinical spectrum of renal osteodystrophy in 57 chronic hemodialysis patients: a correlation between biochemical parameters and bone pathology findings.
MedLine Citation:
PMID:  2019018     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fifty-nine chronic hemodialysis patients who had been on dialysis for an average of 77 months underwent bone biopsies and the pathologic findings were correlated with biochemical and demographic data. All but two had evidence of renal osteodystrophy, 23 with osteitis fibrosa (OF), 19 with osteomalacia and/or adynamic disease (OM/AD), and 15 with mixed osteodystrophy (MOD). Patients in each group were similar with regard to age, sex distribution, duration of dialysis, unstimulated serum aluminum, calcium and phosphorus. Patients with osteitis fibrosa (OF) had statistically higher DFO stimulated aluminum, alkaline phosphatase and PTHC levels than the other two groups although there was marked individual variation. The bone biopsies were also evaluated for the amount of aluminum deposited in the osteoid seam. All 23 of the patients with OF and 11 of the 15 patients with MOD had no, mild, or minimal aluminum deposition but 12 of the 19 patients with OM/AD had moderate to marked aluminum deposition. Patients with minimal to mild aluminum deposition were similar in age, duration of dialysis, sex distribution, unstimulated and DFO stimulated aluminum levels, calcium, phosphorus, alkaline phosphatase to those with moderate to marked deposition but had significantly higher parathormone levels. All patients had been treated in a similar fashion regarding diet, oral phosphate binders and vitamin D; therefore, the observed differences in bone pathology were not readily explicable. However, patients who were found to have osteitis fibrosa and those with minimal to mild aluminum deposition had significantly higher parathormone levels when compared with patients in the other groups at the inception of dialysis.
Authors:
J A Chazan; N P Libbey; M R London; L Pono; J G Abuelo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  35     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  1991 Feb 
Date Detail:
Created Date:  1991-05-24     Completed Date:  1991-05-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  78-85     Citation Subset:  IM    
Affiliation:
Department of Medicine, Rhode Island Hospital, Providence 02903.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Alkaline Phosphatase / blood
Aluminum / blood,  metabolism
Bone Diseases / pathology
Bone and Bones / metabolism,  pathology*
Calcium / blood
Female
Fibrosis
Humans
Male
Middle Aged
Osteitis Fibrosa Cystica / pathology
Osteomalacia / pathology
Parathyroid Hormone / blood
Phosphorus / blood
Renal Dialysis*
Renal Osteodystrophy / blood,  pathology*
Time Factors
Chemical
Reg. No./Substance:
0/Parathyroid Hormone; 7429-90-5/Aluminum; 7440-70-2/Calcium; 7723-14-0/Phosphorus; EC 3.1.3.1/Alkaline Phosphatase

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