Osteosclerosis Associated With Chronic Renal Failure

Crawford, Thomas; Dent, C. E.; Lucas, Pamela; Martin, N. H.; Nassim, J. R.

doi:10.1016/s0140-6736(54)90540-1

Cited by 64 publications

(14 citation statements)

References 5 publications

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“…Osteosclerosis has been increasingly recognized as a feature of renal osteodystrophy in recent years (Ginzler and Jaffe, 1941;Gilmour, 1947;Claireaux, 1953;Crawford, Dent, Lucas, Martin, and Nassim, 1954;Kaye, Pritchard, Halpenny, and Light, 1960;Haust et al, 1964 Azotaemic renal osteodystrophy: a quantitative study on iliac bone commonly due to an accumulation of non-mineralized bone and that mineralized bone is often also increased in these patients. Thus in the present series, of the 18 patients with osteosclerosis the mineralized bone values were at the upper range of normal in four and raised above normal in 11.…”

Section: Osteosclerosismentioning

confidence: 99%

Azotaemic renal osteodystrophy: a quantitative study on iliac bone

1973

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SYNOPSISThe histopathology of bone is described in 60 patients with chronic renal failure due to a variety of renal diseases. Changes of azotaemic renal osteodystrophy included osteitis fibrosa, osteomalacia, and osteosclerosis. Quantitative histology using a point-counting technique revealed a significant increase in total bone, mineralized bone, and osteoid in comparison with a control group of 68 individuals. Osteitis fibrosa due to secondary hyperparathyroidism occurred in 93 %, osteomalacia in 40%, and osteosclerosis in 30% of patients. Woven bone formation was a characteristic feature and was related to the severity of osteitis fibrosa. There were significant correlations between the weights of parathyroid glands and the number of osteoclasts, amounts of woven bone, and marrow fibrosis in the ilium. Hyperparathyroidism caused degradation of mineralized bone but the loss was balanced or exceeded by the aggradation of woven mineralized bone. Woven bone formation together with excess osteoid gave rise to osteosclerosis. The histological findings indicate that hyperparathyroidism and osteitis fibrosa usually occur early in chronic renal failure and that osteomalacia develops subsequently.Chronic renal failure may be accompanied by bone disease (Stanbury, 1957(Stanbury, , 1972 and the changes, which include osteitis fibrosa due to secondary hyperparathyroidism, osteomalacia and osteosclerosis, may conveniently be termed renal osteodystrophy (Liu and Chu, 1943). Although it is recognized that the clinical effects of such changes may be severe in childhood (Claireaux, 1953;Haust, Landing, Holmstrand, Currarino, and Smith, 1964) 20 December 1972. in this study it appeared that there were histological differences between the bone changes in dialysed and non-dialysed patients. The latter tended to show osteitis fibrosa, osteomalacia, and a normal or raised total bone mass with normal or elevated amounts of mineralized bone. In contrast, in the bones of dialysed patients there was a loss of mineralized lamellar bone and total bone after about one or two years on dialysis. In others, following more prolonged dialysis, the total bone mass was elevated due to excess osteoid formation whilst the amount of mineralized bone remained low. The bones of dialysed patients in general also showed less severe changes of osteitis fibrosa (Ellis and Peart, 1971).To determine whether or not these differences were real it became necessary to quantitate the amounts of mineralized bone and osteoid present and the severity of the osteitis fibrosa. Critical quantitative histological studies of the mineralized and non-mineralized bone in renal failure were lacking until Garner and Ball (1966) reported their findings in 42 controls and in 18 selected cases of azotaemic renal osteodystrophy using a pointcounting technique to study undecalcified sections of iliac crest. As a basis for our quantitative observations in renal failure we have similarly studied the 83

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Section: Osteosclerosismentioning

confidence: 99%

Azotaemic renal osteodystrophy: a quantitative study on iliac bone

1973

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“…3), showed clear signs of osteosclerosis in that the upper and lower borders of each vertebra were more dense than normal to give the appearance of horizontal bands previously described as the " rugger-jersey sign " (Dent, 1955). This triple combination of hyperparathyroidism, osteomalacia, and osteosclerosis has been previously described only, so far as we know, in chronic renal failure (Crawford et al, 1954). This observation is most intriguing, for the usual explanations given for the pathogenesis of renal osteodystTophy can hardly have been applicable to this patient, whose renal function as ordinarily measured was normal and whose plasma levels of calcium and phosphorus were unlike those occurring in renal failure.…”

Section: Discussionmentioning

confidence: 66%

Hyperparathyroidism and Steatorrhoea

Dent¹

1956

BMJ

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“…Während die meisten dieser Erkrankungen zahlreiche radiologische Befunde mit der Involutionsosteoporose gemein haben und nur mit weiteren klinischen und laborchemischen Tests von dieser zu differenzieren Druckatrophie, Deformitäten und Spontanfrakturen sowie umschriebende oder diffuse Hyperostosen [95]. Letztere treten bevorzugt bei Patienten mit renaler Osteodystrophie und sekundä-rem Hyperparathyreoidismus auf [13,14]. Durch die Spongiosklerose in den subchondralen Abschnitten der Wirbelkörper entsteht radiologisch der Eindruck einer Dreischichtung.…”

Section: Andere Erkrankungen Mit Generalisierter Osteopenieunclassified

Konventionelle Radiologie der Osteoporose und Röntgenabsorptiometrie

Jergas

Schmid

1999

Der Radiologe

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Radiographic findings suggestive of osteopenia and osteoporosis are frequently encountered in daily medical practice and can result from a wide spectrum of diseases ranging from highly prevalent causes such as postmenopausal and involutional osteoporosis to very rare endocrinologic and hereditary or acquired disorders. As bone mass is lost, changes in the trabecular and cortical bone structure occur. The changes that are visible on conventional radiographs may give specific information on the etiology of the underlying disease. Even though conventional radiography is indispensable in the differential diagnosis of osteopenia and osteoporosis, visual assessment of bone mass and its changes is subjective and strongly depends on the radiographic technique. With radiogrammetry and radiographic absorptiometry two methods exist that rely on conventional radiography and allow for a quantification of bone mass.

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Osteosclerosis Associated With Chronic Renal Failure

Cited by 64 publications

References 5 publications

Azotaemic renal osteodystrophy: a quantitative study on iliac bone

Azotaemic renal osteodystrophy: a quantitative study on iliac bone

Hyperparathyroidism and Steatorrhoea

Konventionelle Radiologie der Osteoporose und Röntgenabsorptiometrie

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