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Renal refers to the kidneys. Renal osteodystrophy is a bone disease that
occurs when kidneys fail to maintain the proper levels of calcium and phosphorus
in the blood. It's common to patients with kidney disease especially patients
has taken dialysis.
Renal osteodystrophy is most serious in children because their bones are
still growing. The disease can lead to deformities and short stature. Symptoms
can be seen in growing children with renal disease even before they start
dialysis. The bone changes from renal osteodystrophy can begin many years before
symptoms appear in adults with kidney disease. The symptoms of renal
osteodystrophy usually can not be seen in adults until they have been on
dialysis for several years. If left untreated, the bones gradually become thin
and weak, and a person with renal osteodystrophy may begin to feel bone and
joint pain. There's also an increased risk of bone fractures.
The pathology of renal osteodystrophy is related to metabolic disorders Of
Calcium, Phosphorus and Vitamin D.
If calcium levels in the blood become too low, the parathyroid glands can
release a hormone called parathyroid hormone (PTH). This hormone draws calcium
from the bones to raise blood calcium levels. Too much PTH in the blood will
remove too much calcium from the bones; over time, the constant removal of
calcium weakens the bones.
Phosphorus can regulate calcium levels in the bones. Healthy kidneys can
remove excess phosphorus from the blood. When the kidneys stop working normally,
phosphorus levels in the blood can become too high, leading to lower levels of
calcium in the blood and resulting in the loss of calcium from the bones
Healthy kidneys produce calcitriol, a form of vitamin D, which can help the
body absorb calcium in diet into the blood and the bones. Calcitriol and PTH
work together to keep calcium balance and bones healthy. If calcitriol level
drop too low and PTH level increase, calcium will be removed from the bones. In
a patient with kidney failure, the kidneys stop making calcitriol. The body then
can't absorb calcium from food and starts removing it from the bones.
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