Bone histomorphometry is a quantitative histological examination of an undecalcified bone biopsy performed to obtain quantitative information on bone remodeling and structure. Labeling agents taken before the procedure deposit at sites of bone formation allowing a dynamic analysis. Biopsy is indicated to make the diagnosis of subclinical osteomalacia, to characterize the different forms of rena...

OBJECTIVE It is important to estimate the bone metabolism in patients with renal osteodystrophy. The methods of estimation must be noninvasive, accurate, and able to measure repeatedly. METHODS The regions of interest on bone scintigraphy were drawn over the radius in 22 hemodialysis patients (10 males, 12 females). The bone/soft tissue ratio (B/ST ratio) was calculated for all patients. The ...

Pathological fractures after minor trauma in osteopenic patients are not uncommon, but fractures due to hypocalcemic convulsions in patients with renal insufficiency are relatively rare. Though similar cases have been reported in the literature, this type of fracture is still an unusual condition. The complex underlying pathophysiological mechanisms and the poor bone mineral density signify the...

Oral manifestations of severe secondary hyperparathyroidism include maxillary and mandibular deformities, brown tumors, dental abnormalities, and metastatic calcification of soft tissues. We report on a chronic hemodialysis (HD) woman with severe, uncontrolled secondary hyperparathyroidism and a painful, nontender mass in the floor of her mouth. The most likely clinical diagnosis was a bone tum...

Renal osteodystrophy (ROD) is a multifactor disorder of bone remodelling observed in patients with chronic renal failure (CRF) from very early stages (CRF stage 2) and associated with significant morbidity. The remodelling cycle in normal bone lasts from four to eight months and includes several phases: 1) An activation phase in which osteoclasts are mobilized and activated; 2) A resorption pha...

An 81-yr-old African-American woman with endstage kidney disease (ESKD) who has been on hemodialysis for 10 yr seeks a consultation with you. Her primary physician obtained a dual-energy xray absorptiometry (DEXA) scan and asked her to discuss the results with her nephrologist for further management. She is diagnosed with osteoporosis based on her T-scores of 5.1 (AP spine), 4.1 (left femoral n...