adynamic bone disease

Etiology

• end-stage renal disease

Pathology

• associated with vascular calcifications
• inability to repair bone microdamage due to low turnover
• bone is unable to take up calcium

Clinical manifestations

• bone pain

Laboratory

• serum calcium & serum phosphate normal
• serum PTH & serum alkaline phosphatase relatively suppressed

Diagnostic procedures

• bone biopsy is gold standard but rarely done

Complications

• bone fracture

Differential diagnosis

• osteitis fibrosa cystica

Management

• treatment targeted at factors increasing PTH secretion
  • vitamin D (judicious use)
  • decrease calcium in dialysate

More general terms

• renal osteodystrophy