BONE-DISEASE IN MODERATE RENAL-FAILURE - CAUSE, NATURE, AND PREVENTION

There are two primary types of bone disorders observed in patients wit h end-stage renal disease: a high-turnover osteodystrophy characterize d by osteitis fibrosa, and a low-turnover osteodystrophy characterized initially by osteomalacia and, more recently, by adynamic or aplastic bone disease. This article reviews the clinical presentation, pathoge nesis, and laboratory findings of patients with these two disorders. I t discusses the important roles of phosphorus binding, vitamin D admin istration, and correction of acidosis in prevention and treatment of b one disease in patients with moderate renal insufficiency.