A patient with carpotarsal osteolysis and nephropathy treated with long-term hemodialysis

We describe a type III carpotarsal osteolysis patient with nephropathy who has been maintained on chronic hemodialysis for 12 years. The diagnosis of osteolysis was based on x-ray findings and bone biopsy. At the age of 12 years, she developed renal disease that progressed; she was placed on chronic dialysis at the age of 18 years. Blood pressure was controlled by a medical regimen, and her anemia has benefitted from erythropoietin up to a level of 28% to 30%. Her osteolysis has stabilized since the age of 20 years; she is presently 30 years old. The major problem affecting the patient's clinical outcome is hyperphosphatemia.