"Renal osteodystrophy", a term introduced over 51 years ago, is still used to describe any bone disease occuring in a patient with renal disease. In actually, a very wide spectrum of bone disease can occur in renal failure patients, ranging from
states
of makedly impaired bone formation and mineralization (such as low-turnover bone disease, osteomalacia) to states of markedly increased bone turnover(hyperparathyroidism).
We had experienced one case of renal osteodystrophy and secondary hyperaparathyroidism, especially combined with advanced renal failure, who was admitted to Hayang University Hospital due to severe bone pain on both lowe extremites.
Skull X-ray showed decreased bone density with so called "salt and pepper" appearance. Subperiosteal bone resorptions along the ribs and the proximal medial tibial metaphysis were noted on chest PA and both knee X-rays. Serum calcium level was
8.9mg/dl,
serum phosphoros level was 5.6mg/dl, serum alkaline phosphatase was 1872IU/L, serum parathyroid hormone level was 6.54ng/dl(normal; 0.22-0.66ng/dl). Dual photon bone densitometry showed marked decreased total body bone densitometry showed marked
decreased total body bone density. Renal osteodystrophy(osteitis fibrosa) was confirmed by bone biopsy stained with Haematoxylin & Eosin and double tetracycline labelling, and secondary hyperparathyroidism was confirmed by parathroid gland
biopsies. She
was treated with CaCO3, AI(OH)3, Cholecalcitriol after parathyroidectomy.
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