Wednesday, 10 November 2010

MRCP revision battle 45.5: Renal osteodystrophy

Renal osteodystrophy refers to the bone pathology which results from the endocrine and electrolyte imbalances caused by chronic renal failure.

Derangements include:
  • raised phosphate
  • low calcium
  • secondary hyperparathyroidism
  • low vitamin D
  • acidosis

The result on bones include:
  • osteomalacia
  • osteitis fibrosa cystica = hyperparathyroid bone disease
  • osteoporosis
  • osteosclerosis 'rugger jersey' spine

Management is:
  • calcichew - to bind phosphate in the gut
  • vit D analogues - eg adcal D3/calceos/calcichew = colecalciferol

On to the slightly more stimulating contrast nephropathy...