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Related Experiment Videos

Bone disease in long-term dialysis

R Golder1, J A Delmez, S Klahr

  • 1Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St Louis, MO 63110, USA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|December 1, 1996
PubMed
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Long-term dialysis patients often develop skeletal abnormalities like osteitis fibrosa and amyloidosis due to persistent high parathyroid hormone (PTH) levels, even after parathyroid surgery.

Area of Science:

  • Nephrology
  • Endocrinology
  • Orthopedics

Background:

  • Patients on long-term dialysis (12-20 years) can experience significant skeletal complications.
  • Hemodialysis is the primary treatment for most patients studied.

Purpose of the Study:

  • To review clinical features, laboratory findings, and skeletal abnormalities in patients with end-stage renal disease on long-term dialysis.
  • To describe the pathogenesis and treatment of hyperparathyroidism in this cohort.

Main Methods:

  • Retrospective review of six patients undergoing dialysis for over 12 years.
  • Analysis of clinical data, laboratory findings, and bone biopsy results.
  • Evaluation of surgical outcomes for parathyroidectomy.

Main Results:

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  • Predominant bone changes included osteitis fibrosa (3/5 patients) and osteomalacia (2/5 patients).
  • Amyloidosis of bone was observed in all six patients, manifesting as carpal tunnel syndrome, bone cysts, and tendon involvement.
  • Four patients underwent parathyroidectomy with forearm implants, yet all maintained markedly elevated parathyroid hormone (PTH) levels.

Conclusions:

  • Long-term dialysis is associated with severe skeletal abnormalities, including hyperparathyroidism and amyloidosis.
  • Elevated PTH levels persist even after parathyroid surgery in some patients.
  • Comprehensive management strategies are crucial for addressing bone disease in dialysis patients.