Renal Osteodystrophy

Renal Osteodystrophy – General Information

The term renal, which is usually used in the medical world, refers to the kidneys and the diseases related to them. Renal Osteodystrophy is a disease which appears when the kidneys are no longer able to assure a proper level of phosphorus and calcium in the blood. Reports have shown that this disorder is quite common in the case of those who go through dialysis and those who suffer from a kidney disease. This disorder is more serious when it affects young children, because of the fact that, in their case, the growing process is not over yet; these children may present deformities and a slower growth of the bones. This abnormal rhythm of the bone growth is a common cause for a short stature. In what concerns the deformities which can appear, the most common one is known as “renal rickets” and it is characterized by the fact that the sufferer’s legs stand away one form each other or they bend in. Calcium, an important mineral which is present in small quantities in the case of those who suffer from Renal Osteodystrophy has an important role, to build and strengthen the bones. It is usually taken from the products we eat, especially milk. If the levels of calcium in the body are extremely low, the parathyroid glands interfere and they release the parathyroid hormone, which displace the calcium in the bones in order to raise the level of calcium in the blood. If this process continues for a long period of time, it is likely for that person to experience Renal Osteodystrophy.

Renal Osteodystrophy - Symptoms

The important thing which should be known about this disease is the fact that it can be asymptomatic for a long period of time, which means that the sufferer presents no significant signs and symptoms. This is the reason why Renal Osteodystrophy is also known as the silent crippler. This aspect of the disease is usually noticed in the case of adults who go through dialysis. On the other hand, certain categories of people present a higher risk of suffering from this disease: old people and women who experience menopause. This can be explained because these people are already more vulnerable to bone diseases, such as osteoporosis, even without suffering from a bone disease. However, the first signs and symptoms which appear in the case of Renal Osteodystrophy are bone pain, joint pain, a general feeling of weakness and irritability. These symptoms are the result of the fact that the bones gradually become weaker and thinner. If the disease is in a late stage the sufferer may even experience bone fractures or other serious complications. In the case of a healthy adult, the bone tissue is permanently rebuilt and remodeled. In order for this process to go on without any complications, the kidneys play an important role: they maintain a normal structure of the bones and a healthy bone mass. The bone structure and the bone mass are kept normal when the kidneys assure a balanced level of phosphorus and calcium in the blood, which means that they have to receive the necessary quantities of these agents.

Renal Osteodystrophy – Treatment

If you notice the appearance of one or more of the signs and symptoms presented above, you should consult a specialist as soon as possible in order to obtain a sure diagnosis and to benefit from the best way of treatment. In order to obtain information about this disease and to decide whether you suffer or not from Renal Osteodystrophy, your doctor will probably ask you some questions about your medical history and your general health condition; in addition, he will probably take some blood samples in order to measure the levels of phosphorus, calcium and calcitriol in your body. Another test which can be performed is a bone biopsy which offers information about the density of the bones. This procedure consists in a local anesthesia and a simple removal of a bone sample which is then analyzed in the laboratory. After the doctor establishes the diagnosis, another important step is to determine the cause of the disease; this information influence a lot the treatment which is administrate to the patient.

The first measure which must be taken when treating those who suffer from Renal Osteodystrophy is to control the phosphorus levels in their body, as this prevents the withdrawing of calcium from the bones. This can be done by controlling the parathyroid glands; this measure, however, implies a change in what concerns the patient’s diet, his medication and his dialysis treatment. The most common drug which is administrated in order to control the quantity of phosphorus which is produced by the parathyroid glands is cinacalcet hydrochloride. If the patient’s condition is quite bad and the Renal Osteodystrophy is diagnosed in a late stage, the doctor may choose to remove the patient’s parathyroid glands. If the doctor notices the fact that the patient’s kidneys do not produce a normal quantity of calcitriol, he can prescribe synthetic calcitriol which can be administrated either in an injectable form or orally; in addition to this substance, the doctor can also recommend some calcium supplements.

In what concerns the dietary changes which must be done by those who suffer from Renal Osteodystrophy, these usually imply a reduction of the daily quantity of phosphorus which is taken from the food. A high quantity of phosphorus is found in products, such as cheese, milk, peas, peanut butter, nuts and dried beans. In addition to the fact that the patient has to limit the intake of these products, he also has to reduce drinks such as beer and cocoa. Another option in what concerns the diet of those who suffer from Renal Osteodystrophy is that they can combine the foods they eat with some agents in order to reduce the absorption of phosphorus. The most common agents which are used for this are calcium acetate, calcium carbonate and sevelamer hydrochloride. However, in order to choose the best diet, the sufferers should consult a renal dietitian who can also offer them more information about their condition. In some cases, the doctor can also recommend the sufferers to exercise more, as this can influence the bone strength.