Abstract
To identify patients at risk from renal bone disease we compared the demographic characteristics of 243 patients with end stage renal failure grouped according to the presence (97 (40%] or absence of severe renal bone disease as judged by histological criteria. Youth, female sex, tubulointerstitial types of nephropathy, and a long duration of uraemia were all identified as significant independent risk factors for the development of bone disease. The relative risks from being female and having tubulointerstitial renal disease were separately identifiable when the estimated observation of renal failure was short (less than four years). The identification of patients at high risk from bone disease may clarify the pathogenesis and treatment strategies of renal osteodystrophy.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aksnes L., Aarskog D. Plasma concentrations of vitamin D metabolites in puberty: effect of sexual maturation and implications for growth. J Clin Endocrinol Metab. 1982 Jul;55(1):94–101. doi: 10.1210/jcem-55-1-94. [DOI] [PubMed] [Google Scholar]
- Brenner R. J., Spring D. B., Sebastian A., McSherry E. M., Genant H. K., Palubinskas A. J., Morris R. C., Jr Incidence of radiographically evident bone disease, nephrocalcinosis, and nephrolithiasis in various types of renal tubular acidosis. N Engl J Med. 1982 Jul 22;307(4):217–221. doi: 10.1056/NEJM198207223070403. [DOI] [PubMed] [Google Scholar]
- Chesney R. W., Moorthy A. V., Eisman J. A., Jax D. K., Mazess R. B., DeLuca H. F. Increased growth after long-term oral 1alpha,25-vitamin D3 in childhood renal osteodystrophy. N Engl J Med. 1978 Feb 2;298(5):238–242. doi: 10.1056/NEJM197802022980503. [DOI] [PubMed] [Google Scholar]
- Christiansen C., Rødbro P., Christensen M. S., Hartnack B., Transbøl I. Deterioration of renal function during treatment of chronic renal failure with 1,25-dihydroxycholecalciferol. Lancet. 1978 Sep 30;2(8092 Pt 1):700–703. doi: 10.1016/s0140-6736(78)92702-2. [DOI] [PubMed] [Google Scholar]
- Cochran M., Bulusu L., Horsman A., Stasiak L., Nordin B. E. Hypocalcaemia and bone disease in renal failure. Nephron. 1973;10(2):113–140. doi: 10.1159/000180182. [DOI] [PubMed] [Google Scholar]
- Cochran M., Nordin B. E. Role of acidosis in renal osteomalacia. Br Med J. 1969 May 3;2(5652):276–279. doi: 10.1136/bmj.2.5652.276. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cundy T., Kanis J. A., Heynen G., Earnshaw M., Clemens T. L., O'Riordan J. L., Merrett A. L., Compston J. E. Failure to heal D-deficiency rickets and suppress secondary hyperparathyroidism with conventional doses of 1,25-dihydroxy vitamin D3. Br Med J (Clin Res Ed) 1982 Mar 20;284(6319):883–885. doi: 10.1136/bmj.284.6319.883. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eastwood J. B., Stamp T. C., Harris E., de Wardener H. E. Vitamin-D deficiency in the osteomalacia of chronic renal failure. Lancet. 1976 Dec 4;2(7997):1209–1211. doi: 10.1016/s0140-6736(76)91140-5. [DOI] [PubMed] [Google Scholar]
- Ellis H. A., Peart K. M. Azotaemic renal osteodystrophy: a quantitative study on iliac bone. J Clin Pathol. 1973 Feb;26(2):83–101. doi: 10.1136/jcp.26.2.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Holdsworth S., Atkins R. C., de Kretser D. M. The pituitary-testicular axis in men with chronic renal failure. N Engl J Med. 1977 Jun 2;296(22):1245–1249. doi: 10.1056/NEJM197706022962201. [DOI] [PubMed] [Google Scholar]
- Kanis J. A., Cundy T., Earnshaw M., Henderson R. G., Heynen G., Naik R., Russell R. G., Smith R., Woods C. G. Treatment of renal bone disease with 1 alpha-hydroxylated derivatives of vitamin D3. Clinical, biochemical, radiographic and histological responses. Q J Med. 1979 Apr;48(190):289–322. [PubMed] [Google Scholar]
- Kanis J. A., Earnshaw M., Heynen G., Ledingham J. G., Oliver D. O., Russell G. G., Woods C. G., Franchimont P., Gaspar S. Changes in histologic and biochemical indexes of bone turnover after bilateral nephrectomy in patients on hemodialysis. Evidence for a possible role of endogenous calcitonin. N Engl J Med. 1977 May 12;296(19):1073–1079. doi: 10.1056/NEJM197705122961901. [DOI] [PubMed] [Google Scholar]
- Kurokawa K., Torikai S., Wang M. S., Klein K. L., Kawashima H. Metabolic heterogeneity of the nephron. Miner Electrolyte Metab. 1982;7(5):225–236. [PubMed] [Google Scholar]
- Malluche H. H., Ritz E., Lange H. P., Kutschera L., Hodgson M., Seiffert U., Schoeppe W. Bone histology in incipient and advanced renal failure. Kidney Int. 1976 Apr;9(4):355–362. doi: 10.1038/ki.1976.42. [DOI] [PubMed] [Google Scholar]
- Mason R. S., Lissner D., Wilkinson M., Posen S. Vitamin D metabolites and their relationship to azotaemic osteodystrophy. Clin Endocrinol (Oxf) 1980 Oct;13(4):375–385. doi: 10.1111/j.1365-2265.1980.tb03399.x. [DOI] [PubMed] [Google Scholar]
- Mawer E. B., Taylor C. M., Backhouse J., Lumb G. A., Stanbury S. W. Failure of formation of 1,25-dihydroxycholecalciferol in chronic renal insufficiency. Lancet. 1973 Mar 24;1(7804):626–628. doi: 10.1016/s0140-6736(73)92197-1. [DOI] [PubMed] [Google Scholar]
- Meema H. E., Oreopoulos D. G., Uldall P. R. The influence of age and sex on bone resorption of secondary hyperparathyroidism in renal osteodystrophy. Calcif Tissue Int. 1984 Jan;36(1):25–30. doi: 10.1007/BF02405290. [DOI] [PubMed] [Google Scholar]
- Memmos D. E., Eastwood J. B., Talner L. B., Gower P. E., Curtis J. R., Phillips M. E., Carter G. D., Alaghband-Zadeh J., Roberts A. P., de Wardener H. E. Double-blind trial of oral 1,25-dihydroxy vitamin D3 versus placebo in asymptomatic hyperparathyroidism in patients receiving maintenance haemodialysis. Br Med J (Clin Res Ed) 1981 Jun 13;282(6280):1919–1924. doi: 10.1136/bmj.282.6280.1919. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moorhead J. F., Tatler G. L., Baillod R. A., Varghese Z., Wills M. R., Farrow S. C. Effects of age, sex, and polycystic disease on progressive bone disease of renal failure. Br Med J. 1974 Dec 7;4(5944):557–560. doi: 10.1136/bmj.4.5944.557. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mora Palma F. J., Ellis H. A., Cook D. B., Dewar J. H., Ward M. K., Wilkinson R., Kerr D. N. Osteomalacia in patients with chronic renal failure before dialysis or transplantation. Q J Med. 1983 Summer;52(207):332–348. [PubMed] [Google Scholar]
- Mundy G. R., Cove D. H., Fisken R. Primary hyperparathyroidism: changes in the pattern of clinical presentation. Lancet. 1980 Jun 21;1(8182):1317–1320. doi: 10.1016/s0140-6736(80)91783-3. [DOI] [PubMed] [Google Scholar]
- Naik R. B., Cundy T., Robinson B. H., Russell R. G., Kanis J. A. Effects of vitamin D metabolites and analogues on renal function. Nephron. 1981;28(1):17–25. doi: 10.1159/000182088. [DOI] [PubMed] [Google Scholar]
- Ott S. M., Maloney N. A., Coburn J. W., Alfrey A. C., Sherrard D. J. The prevalence of bone aluminum deposition in renal osteodystrophy and its relation to the response to calcitriol therapy. N Engl J Med. 1982 Sep 16;307(12):709–713. doi: 10.1056/NEJM198209163071202. [DOI] [PubMed] [Google Scholar]
- Pendras J. P. Parathyroid disease in long-term maintenance hemodialysis. Arch Intern Med. 1969 Sep;124(3):312–321. [PubMed] [Google Scholar]
- Potter D. E., Wilson C. J., Ozonoff M. B. Hyperparathyroid bone disease in children undergoing long-term hemodialysis; treatment with vitamin D. J Pediatr. 1974 Jul;85(1):60–66. doi: 10.1016/s0022-3476(74)80286-6. [DOI] [PubMed] [Google Scholar]
- Schalch D. S., Gonzalez-Barcena D., Kastin A. J., Landa L., Lee L. A., Zamora M. T., Schally A. V. Plasma gonadotropins after administration of LH-releasing hormone in patients with renal or hepatic failure. J Clin Endocrinol Metab. 1975 Nov;41(5):921–925. doi: 10.1210/jcem-41-5-921. [DOI] [PubMed] [Google Scholar]
- Woods C. G., Morgan D. B., Paterson C. R., Gossmann H. H. Measurement of osteoid in bone biopsy. J Pathol Bacteriol. 1968 Apr;95(2):441–447. doi: 10.1002/path.1700950214. [DOI] [PubMed] [Google Scholar]