Bone remodeling in dialysis. Definition

Medical Definition: bone remodeling in dialysis

The bone lesions of chronic kidney disease (osteodystrophy) differ according to the alterations of bone remodeling, which depends on the serum levels of parathyroid hormone (PTH), vitamin D or calcitriol, calcium, phosphorus, aluminum, degree of metabolic acidosis and other uremic factors. Additional factors include age, type of dialysis and type of renal disease (diabetes). Diseases are classified into high-renovated, with high levels of PTH (increase of osteoblasts and osteoclasts) and mineralization rate of normal or high, which leads to bone marrow fibrosis (osteitis fibrosa) and low remodeling diseases, in this can be to: 1) osteomalacia (decreased number of osteoblasts and osteoclasts, osteoid synthesis deficit, little or no mineralization, predominantly non-mineralized osteoid, aluminum being the most common causative agent), 2) adynamic or aplastic bone disease (reduction bone cell activity and mineralization, is attributed to aluminum, runs with low levels of PTH, is common in peritoneal dialysis programs in diabetics and elderly), and 3) joint disease, in which lesions associated with high and low remodeled. Symptoms (bone pain, brittle bones, periarthritis, fractures, pruritus, etc..) Are nonspecific and only a biopsy can clarify the type of remodeling and possible responsible entity.

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