Renal osteodystrophy in patients on hemodialysis for more than 10 years.

Abstract

We performed bone biopsies on 13 patients who had been on dialysis from 11.1 to 17.6 years (mean 14.5 +/- 2.1 years) to evaluate renal osteodystrophy in long-term dialysis patients. Seven patients had osteitis fibrosa and 6 had a mineralization defect. Stainable bone aluminum was present in 9 of the patients. Serum phosphorus and parathyroid hormone levels were higher and bone aluminum lower in patients with osteitis fibrosa compared to those with a mineralization defect. Those seriously disabled with decreased mobility due to bone pain (7 of 13) had more bone aluminum than those patients with minimal or no disability (1.55 +/- 1.0 mm/mm2 vs. 0.11 +/- 0.18, respectively, p less than 0.01). A history of fractures during the years on dialysis was also associated with elevated stainable bone aluminum (p = 0.04). We conclude that in long-term dialysis patients aluminum-related osteodystrophy results in greater morbidity than osteitis fibrosa. We recommend that aluminum-containing phosphate binders be used sparingly in patients who are to remain indefinitely on dialysis.

• Authors: B M Piraino, R Rault, J H Dominguez, J B Puschett
• Journal: Mineral and electrolyte metabolism (Miner Electrolyte Metab) Vol. 12 Issue 5-6 Pg. 390-6 ( 1986) ISSN: 0378-0392 [Print] Switzerland
• PMID: 3807834 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)

Topics

• Adult
• Aged
• Biopsy
• Bone and Bones (pathology)
• Chronic Kidney Disease-Mineral and Bone Disorder (etiology)
• Female
• Humans
• Male
• Middle Aged
• Renal Dialysis (adverse effects)
• Time Factors