renal rickets

腎性くる病

関

renal osteodystrophy

WordNet

1. childhood disease caused by deficiency of vitamin D and sunlight associated with impaired metabolism of calcium and phosphorus (同)rachitis

PrepTutorEJDIC

1. くる病
2. 腎臓の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/13 01:20:44」(JST)

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Renal osteodystrophy
Classification and external resources
ICD-10	N25.0
ICD-9	588.0
eMedicine	radio/500
MeSH	D012080

Renal osteodystrophy or chronic kidney disease-mineral and bone disorder (CKD-MBD) is a bone pathology, characterized by bone mineralization deficiency, that is a direct result of the electrolyte and endocrine derangements that accompany chronic kidney disease. Renal osteodystrophy can be further divided into metabolic states associated with either high or low bone turnover.

Signs and symptoms

Renal osteodystrophy may exhibit no symptoms; if it does show symptoms, they include:

• Bone pain
• Joint pain
• Bone deformation
• Bone fracture

Diagnosis

Renal osteodystrophy is usually diagnosed after treatment for end-stage renal disease begins. Blood tests will indicate decreased calcium and calcitriol (vitamin D) and increased phosphate and parathyroid hormone. X-rays will also show bone features of renal osteodystrophy (chondrocalcinosis at the knees and pubic symphysis, osteopenia and bone fractures) but may be difficult to differentiate from other conditions.

Pathogenesis

Renal osteodystrophy is thought to be the result of hyperparathyroidism secondary to hyperphosphatemia combined with hypocalcaemia, both of which are due to decreased excretion of phosphate by the damaged kidney. Low activated vitamin D₃ levels are a result of the damaged kidneys' inability to convert vitamin D₃ into its active form, calcitriol, and result in further hypocalcaemia.

Differential diagnosis

To confirm the diagnosis, renal osteodystrophy must be distinguished from the following:

• osteoporosis
• osteopenia
• osteomalacia

Treatment

Treatment for renal osteodystrophy includes the following:

• calcium and vitamin D supplementation
• restriction of dietary phosphate
• phosphate binders such as calcium carbonate, calcium acetate, sevelamer hydrochloride, or lanthanum carbonate
• cinacalcet
• renal transplantation
• hemodialysis five times a week is thought to be of benefit

Prognosis

Recovery from renal osteodystrophy has been observed post renal transplantation. Renal osteodystrophy is a chronic condition with a conventional hemodialysis schedule.

References

External links

• Renal Osteodystrophy - NKUDIC, NIH

UpToDate Contents

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• 1. 小児におけるくる病の概要 overview of rickets in children
• 2. 遺伝性低リン血症性くる病と腫瘍誘発性骨軟化症 hereditary hypophosphatemic rickets and tumor induced osteomalacia
• 3. 慢性腎疾患を有する小児における骨代謝および腎性骨異栄養症 bone metabolism and renal osteodystrophy in children with chronic kidney disease
• 4. 小児における低カルシウム血症性くる病の病因および治療 etiology and treatment of calcipenic rickets in children
• 5. デント病（X連鎖劣性腎結石症） dents disease x linked recessive nephrolithiasis

English Journal

• Update on Mineral and Bone Disorders in Chronic Kidney Disease.

• Foster JD1.
• The Veterinary clinics of North America. Small animal practice.Vet Clin North Am Small Anim Pract.2016 Nov;46(6):1131-49. doi: 10.1016/j.cvsm.2016.06.003. Epub 2016 Jul 16.
• The inappropriate phosphorus retention observed in chronic kidney disease is central to the pathophysiology of mineral and bone disorders observed in these patients. Subsequent derangements in serum fibroblast growth factor 23, parathyroid hormone, and calcitriol concentrations play contributory rol
• PMID 27436330

• The role of bone biopsy for the diagnosis of renal osteodystrophy: a short overview and future perspectives.

• Carvalho C1,2,3,4, Alves CM1,2,3, Frazão JM5,6,7,8.
• Journal of nephrology.J Nephrol.2016 Oct;29(5):617-26. doi: 10.1007/s40620-016-0339-9. Epub 2016 Jul 29.
• Chronic kidney disease (CKD) patients present specific bone and mineral metabolism disturbances, which account for important morbidity and mortality. The term renal osteodystrophy, classically used for the nomination of CKD-associated bone disorder, has been limited to the histologic description of
• PMID 27473148

• Only minor differences in renal osteodystrophy features between wild-type and sclerostin knockout mice with chronic kidney disease.

• Cejka D1, Parada-Rodriguez D2, Pichler S2, Marculescu R3, Kramer I4, Kneissel M4, Gross T5, Reisinger A5, Pahr D5, Monier-Faugere MC6, Haas M2, Malluche HH6.
• Kidney international.Kidney Int.2016 Oct;90(4):828-34. doi: 10.1016/j.kint.2016.06.019. Epub 2016 Aug 12.
• Renal osteodystrophy affects the majority of patients with advanced chronic kidney disease (CKD) and is characterized by progressive bone loss. This study evaluated the effects of sclerostin knockout on bone in a murine model of severe, surgically induced CKD in both sclerostin knockout and wild-typ
• PMID 27528549

Japanese Journal

• The Role of Sodium-Dependent Phosphate Transporter in Phosphate Homeostasis

• Journal of Nutritional Science and Vitaminology 61(Supplement), S119-S121, 2015
• NAID 130005109878

• Relationship between sodium-dependent phosphate transporter (NaPi-IIc) function and cellular vacuole formation in opossum kidney cells

• The Journal of Medical Investigation 62(3.4), 209-218, 2015
• NAID 130005099143

• 低年齢でくる病を呈したDent 病の本邦男児の1 例

• 日本小児腎臓病学会雑誌 26(2), 297-303, 2014
• NAID 130004495425

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★リンクテーブル★

リンク元	「腎性くる病」
関連記事	「renal」

「腎性くる病」

　　[★]

英

renal rickets

関

くる病

「renal」

　　[★]

• adj.

• 腎臓の、腎性の、腎の

関

kidney、renally