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Renal Osteodystrophy

  1. Renal osteodystrophy is more common in CRF because of congenital or hereditary conditions & is distinctly different from either nutritional or hypophosphatemic rickets. It is driven by presence of secondary hyperparathyroidism.
  2. Seen in children who develop renal disease in infancy or early childhood, more commonly a congenital or hereditary condition causing renal failure.
  3. Pathophysiology begins with damaged glomerulus inability to excrete phosphorus hyperphosphatemia causing decreased production of dihydroxy Vit D → Hypocalcemia → Secondary hyperparathyroidism (↑ PTH) → Demineralization of bone to increase S. Ca++, but hyper phosphatemia worsens.
  4. Ectopic calcification occurs.
  5. Osteosclerosis when present, is most common at the base of the skull and in vertebra causing horizontal stripped rugger jersey appearance.
  6. PTH stimulates osteoclast causing osteitis fibrosa cystica.

Osteitis fibrosa cystica

Rugger Jersy

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