Clin Osteol 2005; 10(4): 75-79

New directions and findings in the concept of renal osteopathyReview articles

I. Sotorník, P. Bubeníček, C. Povýšil

The renal osteopathy (RO) is traditionally sorted by different stages of bone turnover: high turnover, represented by secondary hyperparathyroidism; and low bone turnover, characterized by osteomalatic syndrome and adynamic bone disease; intermediate forms can occur as well. The histomorphologic evaluation ofbone tissue remains the gold standard for diagnosis of RO. New aspects in the field of RO have the follwing implications: 1. The key factor of calcium and phosphate homeostasis and the pathogenesis of secondary hyperparathyroidism are the calcium sensing receptors localized at the surface of parathyroid and renal tubular cells. 2. The phosphate homeostasis is strongly influenced by the phosphaturic factors: phosphatonins. 3. The essential question in the RO diagnosis is the validity of parathyroid hormone (PTH) analysis. Currently used IRMA methods detecting intact PTH are burdened by various portion of PTH fragments, thus increasing the final results of the measurements. 4. From the pathogenetic point of view, very im­ portant role is played by the local factors and growth factors of bone metabolism. 5. As the patients on dialysis grow old, significant skeletal demine­ ralization can be anticipated. 6. 50 % of all deceased patients on dialysis die of in calcium-phosphate metabolism are likely to contribute to these causes of deaths.

Keywords: classification of renal ost

Published: December 11, 2005  Show citation