Renal osteodystrophy is currently defined as an alteration of bone morphology in patients with chronic kidney disease (CKD).[1] It is one measure of the skeletal component of the systemic disorder of chronic kidney disease-mineral and bone disorder (CKD-MBD).[1][2][3] The term "renal osteodystrophy" was coined in 1943,[4] 60 years after an association was identified between bone disease and kidney failure.[5]
The traditional types of renal osteodystrophy[6] have been defined on the basis of turnover and mineralization as follows: 1) mild, slight increase in turnover and normal mineralization; 2) osteitis fibrosa, increased turnover and normal mineralization; 3) osteomalacia, decreased turnover and abnormal mineralization; 4) adynamic, decreased turnover and acellularity; and, 5) mixed, increased turnover with abnormal mineralization.[1] A Kidney Disease: Improving Global Outcomes report has suggested that bone biopsies in patients with CKD should be characterized by determining bone turnover, mineralization, and volume (TMV system).[2]
On the other hand, CKD-MBD is defined as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of the following: 1) abnormalities of calcium, phosphorus, PTH, or vitamin D metabolism; 2) abnormalities in bone turnover, mineralization, volume, linear growth, or strength (renal osteodystrophy); and 3) vascular or other soft-tissue calcification.[1][7]
^ abcdEckardt, Kai-Uwe; Kasiske, Bertram L. (August 2009). "KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)" (PDF). Kidney International Supplements. 76 (113). Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group: S1–130. doi:10.1038/ki.2009.188. PMID 19644521.
^ abMoe S, Drüeke T, Cunningham J, Goodman W, Martin K, Olgaard K, Ott S, Sprague S, Lameire N, Eknoyan G (June 2006). "Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO)". Kidney International. 69 (11): 1945–53. doi:10.1038/sj.ki.5000414. PMID 16641930.
^"ERA-EDTA Working Group on Chronic Kidney Disease and Mineral Bone Disorder (CKD-MBD)". Retrieved 4 February 2016.
^Lui S, Chu H (1943). "Studies in calcium and phosphorus metabolism with special reference to pathogenesis and effects of dihydrotachysterol (A.T.10) and iron". Medicine. 22 (2): 103–107. doi:10.1097/00005792-194305000-00002.
^Lucas RC (1833). "Form of late rickets associated with albuminuria, rickets of adolescents". The Lancet. 1 (3119): 993–994. doi:10.1016/S0140-6736(02)37965-0.
^Llach F, Bover J (2000). "Renal Osteodystrophies". In Brenner BM (ed.). The Kidney. Philadelphia: W.B. Saunders Company. pp. 2103–2186. ISBN 978-0-7216-7998-3.
^Cozzolino M, Ureña-Torres P, Vervloet MG, Brandenburg V, Bover J, Goldsmith D, Larsson TE, Massy ZA, Mazzaferro S (October 2014). "Is chronic kidney disease-mineral bone disorder (CKD-MBD) really a syndrome?" (PDF). Nephrology, Dialysis, Transplantation. 29 (10): 1815–20. doi:10.1093/ndt/gft514. PMID 24516228.
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