腎性くる病
- 関
- renal osteodystrophy
WordNet
- childhood disease caused by deficiency of vitamin D and sunlight associated with impaired metabolism of calcium and phosphorus (同)rachitis
PrepTutorEJDIC
- くる病
- 腎臓の
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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)[1] 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.
Contents
- 1 Signs and symptoms
- 2 Diagnosis
- 3 Pathogenesis
- 4 Differential diagnosis
- 5 Treatment
- 6 Prognosis
- 7 References
- 8 External links
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[2]
Prognosis
Recovery from renal osteodystrophy has been observed post renal transplantation. Renal osteodystrophy is a chronic condition with a conventional hemodialysis schedule.[2]
References
- ^ Svára F (March 2009). "Chronic kidney disease-mineral and bone disorder (CKD-MBD): a new term for a complex approach". J Ren Care. 35 Suppl 1: 3–6. doi:10.1111/j.1755-6686.2009.00067.x. PMID 19222724.
- ^ a b Bonomini V, Mioli V, Albertazzi A, Scolari P (1998). "Daily-dialysis programme: indications and results". Nephrol. Dial. Transplant. 13 (11): 2774–7; discussion 2777–8. doi:10.1093/ndt/13.11.2774. PMID 9829478.
External links
- Renal Osteodystrophy - NKUDIC, NIH
Osteochondropathy (M80–M94, 730–733)
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Osteopathies |
Osteitis |
endocrine bone disease: |
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infectious bone disease: |
- Osteomyelitis
- Sesamoiditis
- Brodie abscess
- Periostitis
- Vertebral osteomyelitis
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Bone density
and structure |
Density / metabolic bone disease |
- Osteoporosis
- Osteopenia
- Osteomalacia
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Continuity of bone |
- Pseudarthrosis
- Stress fracture
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Other |
- Fibrous dysplasia
- Skeletal fluorosis
- bone cyst
- Hyperostosis
- Infantile cortical hyperostosis
- Osteosclerosis
- Pycnodysostosis
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Bone resorption |
- Osteolysis
- Hajdu-Cheney syndrome
- Ainhum
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Ischemia |
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Other |
- Paget's disease of bone
- Algoneurodystrophy
- Hypertrophic pulmonary osteoarthropathy
- Nonossifying fibroma
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Chondropathies |
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Both |
Osteochondritis |
- Osteochondritis dissecans
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Juvenile osteochondrosis |
leg: |
- hip
- Legg–Calvé–Perthes syndrome
- tibia
- Osgood-Schlatter disease
- Blount's disease
- foot
- Köhler disease
- Sever's disease
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spine |
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arm: |
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anat (c/f/k/f, u, t/p, l)/phys/devp/cell
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noco/cong/tumr, sysi/epon, injr
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- Urinary system
- Pathology
- Urologic disease / Uropathy (N00–N39, 580–599)
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Abdominal |
Nephropathy/
(nephritis+
nephrosis) |
Glomerulopathy/
glomerulitis/
(glomerulonephritis+
glomerulonephrosis) |
Primarily
nephrotic |
Non-proliferative |
- Minimal change
- Focal segmental
- Membranous
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Proliferative |
- Mesangial proliferative
- Endocapillary proliferative
- Membranoproliferative/mesangiocapillary
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By condition |
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Primarily
nephritic,
RPG |
Type I RPG/Type II hypersensitivity |
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Type II RPG/Type III hypersensitivity |
- Post-streptococcal
- Lupus
- IgA/Berger's
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Type III RPG/Pauci-immune |
- Granulomatosis with polyangiitis
- Microscopic polyangiitis
- Churg–Strauss syndrome
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Tubulopathy/
tubulitis |
Proximal |
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Thick ascending |
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Distal convoluted |
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Collecting duct |
- Liddle's syndrome
- RTA
- Diabetes insipidus
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Renal papilla |
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Major calyx/pelvis |
- Hydronephrosis
- Pyonephrosis
- Reflux nephropathy
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Any/all |
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Interstitium |
- Interstitial nephritis
- Pyelonephritis
- Danubian endemic familial nephropathy
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Any/all |
General syndromes |
- Renal failure
- Acute renal failure
- Chronic kidney disease
- Uremic pericarditis
- Uremia
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Vascular |
- Renal artery stenosis
- Renal ischemia
- Hypertensive nephropathy
- Renovascular hypertension
- Renal cortical necrosis
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Other |
- Analgesic nephropathy
- Renal osteodystrophy
- Nephroptosis
- Abderhalden–Kaufmann–Lignac syndrome
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Ureter |
- Ureteritis
- Ureterocele
- Megaureter
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Pelvic |
Bladder |
- Cystitis
- Interstitial cystitis
- Hunner's ulcer
- Trigonitis
- Hemorrhagic cystitis
- Neurogenic bladder dysfunction
- Bladder sphincter dyssynergia
- Vesicointestinal fistula
- Vesicoureteral reflux
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Urethra |
- Urethritis
- Non-gonococcal urethritis
- Urethral syndrome
- Urethral stricture/Meatal stenosis
- Urethral caruncle
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Any/all |
- Obstructive uropathy
- Urinary tract infection
- Retroperitoneal fibrosis
- Urolithiasis
- Bladder stone
- Kidney stone
- Renal colic
- Malakoplakia
- Urinary incontinence
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noco/acba/cong/tumr, sysi/epon, urte
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proc/itvp, drug (G4B), blte, urte
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UpToDate Contents
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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
- 低年齢でくる病を呈したDent 病の本邦男児の1 例
★リンクテーブル★
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- 英
- renal rickets
- 関
- くる病
[★]
- 関
- kidney、renally