| Theme |
Hypoparathyroidism and Related Problems in Dialysis Patients |
| Title |
Bone histopathology and bone mineral density on hypoparathyroidism |
| Author |
Toru Uchiyama |
Department of Orthopedic Surgery, Niigata University School of Medicine |
| Author |
Tatsuhiko Tanizawa |
Department of Orthopedic Surgery, Niigata University School of Medicine |
| [ Summary ] |
Among patients on hemodialysis, it has been reported that there are a number who do not respond to exogenous PTH stimulation. These patients are considered to have hypoparathyroidism but only a few reports have addressed bone mineral density in these subjects. As the hypoparathyroid state leads to low bone turnover, bone loss appears to be lower than in patients with a normal PTH level. On the other hand, it was reported that bone mineral densites did not differ from those of patients with normal PTH levels. Low turnover bone was classified as being attributable to osteomalacia or adynamic bone disease. Excess osteoid accumulated because of a mineralization disorder in osteomalacia. Both osteoid formation and mineralization were disturbed in adynamic bone disease. Thin osteoid and the absence of tetracycline labeling were observed frequently in adynamic bone disease. Low turnover bone may be related to bone fragility. However, the relationship between low turnover bone and clinical symptoms remaind. Further study is required on this issue. |