الفهرس | Only 14 pages are availabe for public view |
Abstract Chronic kidney disease (CKD) defined by kidney disease improving global outcomes (KDIGO) as presence of abnormalities of kidney damage structural, functional or a decrease in glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m2 body surface area for ≤ 3 months as shown in Changes in bone architecture can be caused by either a high bone turnover state or a low bone turnover state. Four types of bone phenotypes (renal osteodystrophy) can be diagnosed in CKD patients: osteitis fibrosa cystica (high bone turnover with secondary hyperparathyroidism), osteomalacia (low bone turnover and inadequate mineralization, primarily related to diminished vitamin D synthesis), adynamic bone disorder (low bone turnover from excessive suppression of the parathyroid glands) and mixed osteodystrophy (with elements of both high and low bone turnover). In pre-dialysis patients, high bone turnover bone disease is most prevalent; in contrast, low bone turnover predominates in dialysis patients. Patients with low turnover disease represent the majority of cases of renal osteodystrophy. |