Various musculoskeletal manifestations of chronic renal insufficiency

Severe maxillofacial renal osteodystrophy in two patients with chronic kidney disease

“…Hyperphosphatemia can act by directly stimulating PTH synthesis and parathyroid hyperplasia and indirectly promoting HPT-II by decreasing the serum calcium level [1,2,10]. Excess of PTH acts in the transformation of the inactive form of vitamin D to 1,25-dihydroxyvitamin D 3 in the kidney and influences the development and activity of osteoclasts, osteoblasts, and osteocytes, thereby affecting bone turnover [1,4].…”

“…Those features were present in patient 2, justifying the diagnosis of osteitis fibrosa. On the other hand, osteomalacia is characterized by defective mineralization and increased osteoid production mainly caused by the decrease of 1,25-dihydroxyvitamin D 3 concentrations, usually causing osseous pain and musculoskeletal disability and making the patient at risk of osteopenia, bone deformity, and fracture [1,4,5]. Adynamic bone disease…”

“…One of the complications that can arise in patients with CKD is the clinical syndrome chronic kidney disease-mineral and bone disorder (CKD-MBD), which involves changes in laboratory tests such as serum calcium, organic phosphate, parathyroid hormone (PTH), and concentrations of vitamin D derivatives; changes in bone turnover; and extraskeletal calcifications [3,4]. Renal osteodystrophy (ROD) has recently been redefined to refer to the bone pathology from this syndrome [5].…”

Brachyonychia Associated with Acroosteolysis in Chronic Kidney Disease: How Phalange Shape Influences Nail Morphology

“…Metabolic: Mainly caused by abnormal levels in serum calcium, phosphate, PTH, and active vitamin D [14]. …”

“…High turnover bone disease results from PTH levels higher than 400 pg/mL, which induces osteoclastogenesis and a compensatory osteoblastogenesis. Yet there is also inhibition of osteoblast function and stimulation of osteoblast apoptosis with the end product of bone resorption [14, 20]. …”