Dickson is a 3-year-old boy, referred by the orthopaedic surgeon to the paediatric clinic for short stature and suspected bowlegs. He was delivered at full term by Caesarean section for maternal short stature. His birth weight was 2.8 kg, and the neonatal history was uneventful. He was thriving well, with satisfactory weight gain; however, his knees appeared to be bent outward and were worsening. Hence, the parents sought medical advice from a paediatric orthopaedic surgeon, who referred him for the management of bowlegs. Upon physical examination, the child weighed 12.7 kg (25th centile), his body height was 93.5 cm (3rd centile), and his head circumference was 53 cm (97th centile). His mother’s height was 144 cm, and his father’s height was 168 cm. He had bilateral genu varum (bowlegs), a bulged forehead, pectus carinatum (pigeon chest), rachitic rosary, exaggerated lumbar lordosis and his wrists appeared swollen. In what ways might Dickson’s skeletal problem be associated with underlying kidney disorders?