Renal osteodystrophy

Renal osteodystrophy is the skeletal part of the mineral and bone disorder seen in chronic kidney disease, in which damaged kidneys fail to balance calcium, phosphorus and hormones, weakening the bones. It affects people with chronic kidney disease, grows more marked as kidney function declines and is most evident in kidney failure, including patients on dialysis. Causes include reduced activation of vitamin D, phosphorus retention and excess parathyroid hormone, which pulls calcium from bone; bone turnover can be high, low or mixed. Adults may have bone and joint pain, often only after many years, whereas children can show growth failure and deformities; fractures are a recognised complication. Diagnosis combines history, examination, blood tests for calcium, phosphorus and parathyroid hormone, imaging and, rarely, bone biopsy. Treatment aims to control mineral and hormone levels through a low-phosphorus diet, phosphate binders, vitamin D therapy, calcimimetics, dialysis, kidney transplant and sometimes parathyroidectomy.

Seek urgent care for a fracture after a minor fall, a hot swollen joint with fever, or sudden severe back pain. See a doctor for joint pain and stiffness lasting more than six weeks, loss of height, or if you have risk factors for weak bones and have never had a bone-density assessment. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.