BONE AND MINERAL METABOLISM IN CHILDHOOD END-STAGE RENAL-DISEASE

The kidney provides the major, if not the only, route for the eliminat ion of certain substances that adversely can affect mineral homeostasi s and bone when accumulated in higher concentrations. Renal osteodystr ophy represents a spectrum from high to low turnover lesions of bone, and the specific pattern may change during the evaluation of chronic r enal failure and as a consequence of specific therapeutic intervention s. This article focuses on the pathogenesis of secondary hyperparathyr oidism, renal bone diseases, and the clinical manifestations of end-st age renal bone diseases, and the clinical manifestations of end-stage renal disease. Biochemical features of the disease are discussed, foll owed by a review of the methods of treatment for renal osteodystrophy.