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adynamic bone disease
Etiology:
- end-stage renal disease
Pathology:
- associated with vascular calcifications
- inability to repair bone microdamage due to low turnover
- bone is unable to take up calcium
Clinical manifestations:
- bone pain
Laboratory:
- serum calcium & serum phosphate normal
- serum PTH & serum alkaline phosphatase relatively suppressed
Special laboratory:
- bone biopsy is gold standard but rarely done
Complications:
- bone fracture
Differential diagnosis:
- osteitis fibrosa cystica
Management:
- treatment targeted at factors increasing PTH secretion
- vitamin D (judicious use)
- decrease calcium in dialysate
General
renal osteodystrophy
References
- Medical Knowledge Self Assessment Program (MKSAP) 18,
American College of Physicians, Philadelphia 2018