| Theme |
Usefulness of bone biopsy in making a diagnosis of ROD -- Its significance and limits |
| Title |
Vitamin D therapy for renal osteodystrophy (ROD) and role of bone biopsies |
| Author |
Izumi Yamamoto |
Division of Kidney and Hypertension, The Jikei University School of Medicine |
| Author |
Hiroyasu Yamamoto |
Division of Kidney and Hypertension, The Jikei University School of Medicine |
| [ Summary ] |
Chronic kidney disease, including end stage renal disease, is usually related to serious bone disease. In addition, glucocorticoid therapy and aging contribute to osteoporosis, with deteriorating bone metabolism. ROD is diagnosed by the character of bone histology and divided into four groups includeing those with osteitis fibrosa, osteomalacia, adynamic bone disease and mixed bone lesions. A K / DOQI practice guideline for ROD has been created to establish the relationship between bone histology and metabolic bone markers. The aim of this therapy is to maintain normal bone structure and normal bone turnover with adequate control of serum calcium, serum phosphorus and intact PTH levels. Vitamin D administration is the most important therapy for osteitis fibrosa and osteomalacia. This paper describes vitamin D therapy and bone biopsies which are the gold standard for the diagnosis of ROD. |