July - September 2005, Volume 1, Issue 3

Zosin I, Bottermann P, Golea O

Cross sectional data in renal osteodystrophy

Acta Endo (Buc) 2005, 1 (3): 299-310
doi: 10.4183/aeb.2005.299

Renal osteodystrophy (RO) encompasses the full range of disorders of mineral metabolism that affects the skeleton in patients with chronic renal failure (CRF). The present study tries to analyze some clinical and biochemical features of RO in a group of cases presenting CRF in hemodialysis program. The study group included 45 cases with different nephropathies. The patients were in a longstanding hemodialysis program (mean period 7.46 ? 8.9 yrs). The cases were divided into three subgroups in relation with the length of dialysis time. The performed determinations comprised: a profile of phospho-calcium metabolism, calciotropic hormones (25-hydroxyvitamin D ? 25 (OH) D3; 1, 25 dihydroxyvitamin D ? 1, 25 (OH)2 D3; serum intact PTH) and serum osseous alkaline phosphatase. Paraclinical investigations were represented by X ray examination of bone and joints (certain sites) and bone mineral density measurements by double energy X-ray absorptiometry (DXA) method. The clinical symptoms and signs of RO were represented by: bone pains, height loss, fractures and acute arthritis. Biochemical assessment showed marked alteration of phosphocalcium metabolism and of the levels of calciotropic hormones, related to the stage of CRF and length of hemodialysis.\r\nThe radiographic aspects displayed different patterns, while DXA revealed in most of studied cases different degrees of bone loss, related to end-stage renal disease and associated factors.

Keywords: renal osteodystrophy, secondary hyperparathyroidism, high serum PTH levels, osseous alkaline phosphatase

Correspondence: Ioana Zosin, Clinic of Endocrinology, County Hospital, No. 1, Bd. Iosif Bulbuca, no. 156, Timisoara, Romania, email: endotim@mail.dnttm.ro