Hemodialysis patients with a unique mineralizing defect unresponsive to 1,25-dihydroxycholecalciferol. Dialysis osteomalacic syndrome.

Abstract

5 patients are described who developed severe osteomalacia with spontaneous fractures after 2-4 years on dialysis. Phosphate control, vitamin D2 therapy and parathyroidectomy were ineffective. These individuals showed a hypercalcemic tendency but little histologic or radiographic evidence of osteitis fibrosa. After parathyroidectomy, the hypercalcemic tendency remained and bone biopsy revealed gross osteomalacia. A 6- to 12-month therapeutic trial with 1,25-dihydroxycholecalciferol (1,25[OH]2D3) in 3 did not arrest skeletal deterioration. 4 subsequently developed dialysis encephalopathy. These patients appear to have a unique mineralizing defect unresponsive to 1,25(OH)2D3. This "dialysis osteomalacic syndrome" may result from toxic substances associated with uremia or the hemodialysis regimen.

• Authors: E C Cameron, J C Prior, H S Ballon
• Journal: Contributions to nephrology (Contrib Nephrol) Vol. 18 Pg. 162-71 ( 1980) ISSN: 0302-5144 [Print] Switzerland
• PMID: 6986229 (Publication Type: Case Reports, Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Dihydroxycholecalciferols
• Ergocalciferols
• Hydroxycholecalciferols
• Parathyroid Hormone
• Alkaline Phosphatase
• Calcium

Topics

• Adult
• Alkaline Phosphatase (blood)
• Bone Diseases (etiology, physiopathology)
• Calcium (blood)
• Clinical Trials as Topic
• Dihydroxycholecalciferols (therapeutic use)
• Ergocalciferols (therapeutic use)
• Female
• Humans
• Hydroxycholecalciferols (therapeutic use)
• Kidney Failure, Chronic (blood, complications, therapy)
• Male
• Middle Aged
• Parathyroid Glands (surgery)
• Parathyroid Hormone (blood)
• Renal Dialysis