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Pierre-Emmanuel Cailleaux1,2, Seddik Benarbia3, Guillaume Allard4
1INSERM U1132, Lariboisière Hospital, University of Paris-Diderot, Paris, France.
Clinical Kidney Journal
|October 30, 2020
Summary
This study highlights hypophosphataemic osteomalacia in a haemodialysis patient. Dietary phosphate restriction led to this condition, which was successfully treated with phosphorus supplementation.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- A haemodialysis patient with periprosthetic fractures and corticosteroid use presented with bone mineral disorders.
- Initial diagnosis suggested mixed renal osteodystrophy, but vitamin D correction failed to improve symptoms.
Observation:
- Clinical signs persisted despite addressing vitamin D insufficiency, raising suspicion for hypophosphataemic osteomalacia.
- No apparent cause for hypophosphataemia was identified, apart from dietary phosphate restrictions.
Findings:
- Phosphorus supplementation led to significant improvements in bone biochemical and histological markers.
- Bone mineral density increased, confirming hypophosphataemic osteomalacia secondary to low phosphate intake.
Implications:
- This case underscores the importance of considering dietary phosphate intake in patients with unexplained osteomalacia.
- Repeated bone biopsies confirmed the diagnosis and monitored treatment response in this complex case.
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