STUDY OF RENAL OSTEODYSTROPHY IN CHRONIC RENAL FAILURE

BACKGROUND The skeletal changes associated with the chronic renal failure were described even before 1855. Virchow in 1855 described the skeletal changes that he noticed in his study of chronic renal failure patients. Apart from its intrinsic clinical interest, renal osteodystrophy provides an opportunity to review various matters viz., (1) Mineral deficiencies in man, (2) The sites and mode of action of Vitamin-D, (3) Relation between crystal nucleation in bone and ionic concentration of Calcium and Phosphorus in plasma, (4) Control of parathyroid activity and secretion. METHODS Fifty cases of chronic kidney disease were included. Patients presenting with acute renal failure and senile osteoporosis (age >65 years) were excluded. Data will be collected by using pre-tested proforma meeting the objectives of the study. Purpose of the study will be carefully explained to the patients and consent will be taken. Relative investigations like (i) Serum calcium, (ii) Serum phosphorus, (iii) Serum alkaline phosphatase, (iv) Serum parathormone (if required), (v) Radiological - USG Abdomen, (vi) Plain X-ray-Lumbar Spine, Hands and Wrists, Skull, Chest. CONCLUSION Clinically evident symptomatic bone disease was noticed in 80% of cases in the present study. Symptomatic skeletal involvement suggests osteomalacia rather than secondary hyperparathyroidism. Serum calcium X phosphorus product was well correlated with bone changes. Degree of renal impairment was well correlated with radiological bone changes.