Renal Osteodystrophy: Clinical Management

The functional and structural alterations of bone observed in patients affected by chronic kidney diseases (CKD) are usually defined as renal osteodystrophy (ROD). The histological aspects of ROD are very heterogeneous and mainly characterized by abnormalities in bone mineralization and turnover, which results in qualitative and quantitative changes of the skeletal tissue with a consequent increased bone frailty (Malluche and Monier-Faugere 2006). The main clinical manifestations of ROD include bone pain, muscular-skeletal structural changes, impaired growth in children, brown tumors (osteoclast [OC] proliferative process), and fractures, which are the most clinically relevant manifestations reported to be two to fourfold more frequent in CKD patients than in age- and gender-matched subjects of the general population (Naylor et al. 2014; Hansen et al. 2016).