Bone Disease in Chronic Renal Failure With Particular Reference to Osteosclerosis

Mineral Analysis of the Fourth Lumbar Vertebra in Health and Renal Failure*

“…Although changes of osteosclerosis are detected first in the lumbar vertebrae, they eventually are seen elsewhere if the patient survives long enough (1,7). The change in the vertebrae has been suggested to result from the transfer of calcium to the spine from the long bones, but there is usually no evidence of demineralization in the long bones, sometimes the reverse, and this would require one part of the skeleton to react differently from another part in response to what is probably a general metabolic change.…”

“…In a previous study of osteosclerosis in chronic renal failure (1), it was noted that this type of bone disease is characteristically seen when renal failure has been present for several years. We wished to confirm that the duration of renal disease is related to the changes in the skeleton and that the radiological appearance is due to an increase in mineral content of the bone and to see whether the calcium and phosphorus are present in the same proportions as are found in healthy individuals.…”

The Effect of Treatment of Acidosis on Calcium Balance in Patients with Chronic Azotemic Renal Disease*

“…Osteomalacia, osteitis fibrosa, and osteosclerosis may be recognized by X ray, singly or in combination, and are found with greater frequency on histologic examination of bone (1)(2)(3). Chronic metabolic acidosis, acquired vitamin D resistance, and secondary hyperparathyroidism have each been con-sidered a factor in the pathogenesis of these disorders (1,4,5).…”

Short-term effects of synthetic human parathyroid hormone-(1--34) administration on bone mineral metabolism in osteoporotic patients.

“…47CaCl2 dissolved in 5-10 ml of sterile acidified isotonic saline was given by rapid injection into an antecubital vein. Plasma samples were taken from the opposite antecubital vein through an indwelling catheter at 2, 4,6,8,11,15,20,25,30,35,45,60,80, 100, 120, 180, 240, 300, 360, 480, 600, and 720 min, and at 1, 1.5, 2, 3, and 4 d after the isotopic injection. These samples were then analyzed for radioactivity and stable calcium.…”

“…It has been impossible to evaluate the effects of low doses of parathyroid hormone on trabecular bone mass in humans in the past because the only available material was bovine parathyroid hormone, which provokes neutralizing antibodies in humans after several weeks of injections (8). It is known, however, that osteosclerosis occasionally develops in patients with mild primary hyperparathyroidism (9,10) and frequently occurs in patients with secondary hyperparathyroidism due to uremia (11)(12)(13).…”