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Title: A study using nondecalcified bone biopsy of the incidence and presentation forms of renal osteodystrophy
Other Titles: Estudio con biopsia ósea sin descalcificar de la incidencia y formas de presentación de la osteodistrofia renal
Authors: Lorenzo Sellares, V.
Torres Ramírez, A.
Hernández Marrero, D.
Rodríguez Pérez, J. 
González Posada, J.
Losada Cabrera, M.
Maceira Cruz, B.
Hernández Nieto, L.
UNESCO Clasification: 32 Ciencias médicas
320714 Osteopatología
240209 Osteología
Keywords: Biopsy
Cohort studies
Kidney failure
Osteitis, et al
Issue Date: 1991
Journal: Medicina Clínica 
Abstract: BACKGROUND: Renal osteodystrophy (ROD) is a common complication of chronic renal failure. Fibrous osteitis and, to a lesser extent, osteomalacia are the predominant lesions. The aim of the present study was to evaluate the prevalence of the different forms of ROD. METHODS: Nondecalcified bone biopsies were evaluated in 100 patients with end-stage renal disease (57 in pre-dialysis and 43 on hemodialysis) in whom biochemical (calcium, phosphorus, alkaline phosphatase, parathyroid hormone) and histomorphometric studies were carried out. Bone biopsies were classified in four histological groups: mild, fibrous osteitis (FO), osteomalacia (OM) and mixed type (FO + OM). RESULTS: 96% of patients had histological findings of ROD with the following distribution: 41% mild; 30% FO; 14% OM; and 11% mixed. The most advanced types of ROD were seen in interstitial renal diseases. Pre-dialysis OM was associated with metabolic acidosis, a low phosphocalcic product and relative hypophosphoremia. Chronic aluminium poisoning was uncommon (7%) and was basically associated with OM. No instance of aluminium poisoning with osteodystrophy and bone fractures was seen. CONCLUSIONS: The most severe histological forms of OM were found in hemodialysis patients with persistent hypophosphoremia and associated with osteosclerosis.
ISSN: 0025-7753
Source: Medicina clínica[ISSN 0025-7753],v. 96(15), p. 561-565 (Abril 1991)
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