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Renal Bone Disease

Renal bone disease, also called renal osteodystrophy, affects 90 percent of kidney dialysis patients and occurs when the kidneys fail to maintain proper levels of hormones and minerals in the body. This type of bone disease is associated with individuals often in late stages of chronic kidney disease. Symptoms generally do not present themselves until the patient has undergone dialysis treatment for several years.

  1. Symptoms

    • Symptoms of renal bone disease include bone pain, joint pain, bone deformity, fractures and decreased mobility. According to the National Kidney and Urologic Diseases Information Clearinghouse (NIDDK), this disease is often called the "silent killer" since kidney patients may be absent of symptoms. Early signs of renal bone disease are high phosphorus, high parathyroid hormone (PTH) levels, red eyes, itching and sores.

    Minerals

    • Calcium, phosphorus and calcitrol are integral minerals of the body and in bone formation. Decreased calcium levels, high levels of phosphorus and depleted calcitrol levels results in a loss of calcium from bones. PTH glands release hormones that remove calcium from the bones to raise calcium levels in the blood. When this occurs, high levels of PTH remove calcium required by the bones and will weaken bones over time.

    Diagnosis

    • Diagnosing renal bone disease starts with blood work. Laboratory tests will be performed to test levels of calcium, phosphorus, PTH and calcitrol. A small sample of bone from the hip, called a bone biopsy, could be used to test bone density. This procedure is typically done under anesthesia and analyzed to determine the progression of osteodystrophy and treatment options.

    Treatment

    • Treatment options for renal bone disease include diet, exercise, medication and dialysis. Consulting with a renal dietician who specializes in patients with chronic kidney failure is an option to ensure essential foods are consumed. Medications are prescribed to bring calcium, phosphorus, calcitrol and PTH levels within normal limits. If conventional treatment is unsuccessful, surgical removal of the PTH glands is an option.

    Renal Bone Disease and Children

    • Renal bone disease is serious when diagnosed in children. The disease has the potential of affecting bone growth by slowing it down and causing bone deformities. Renal rickets is a bone deformity common with renal bone disease causing the legs to bend in an inward and/or outward direction. Another symptom that is possible with renal bone disease in children is a short stature (below average height). In children, symptoms of renal bone disease are generally noticed prior to the start of dialysis treatment.

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