The Spectrum of Renal Osteodystrophy: A Clinical, Biochemical, Radiological and Histopathological Study
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Date
2004-07
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Abstract
The chief mineral source of Jammu province is bauxite, an aluminium ore, so a possibility of water
being heavily polluted with aluminium is prevalent. Hence, in an effort to relate this regional geographical
aspect with aluminium bone disease (ABD) in chronic renal failure (CRF), 50 cases of CRF were
prospectively evaluated. Patients were subjected to a thorough history and clinical examination.
Biochemical parameters along with raiological skeletal survey and iliac crest bone biopsies were
undertaken. Sixty-eight per cent of CRF patients were also consuming aluminium containing phosphate
binders (ACPB) at that time. The study revealed an occurrence of ABD in 10% of CRF patients. It
was found predominantly superimposed upon osteomalacia (8%) and mixed osteodystrophy (2%).
Superimposed ABD on osteomalacia was found more frequently in pre-dialysis (10.8%) than after
haemodialysis group (7.69%). Moreover, the incidence of ABD superimposed on osteomalacia and
mixed osteodystrophy was higher in the ACPB group (14.7%) than the post-haemodialysis group
(7.69%). Correlating, the pre-dialysis, post-haemodialysis and ACPB ingestion status of CRF patients
on one hand and histologically proven ABD on the other, it was deduced that the majority of cases of
CRF having ABD was seen in ACPB ingestion group (14.7%) followed by pre-dialysis (10.8%) and
post-haemodialysis (7.69%) groups. Thus it was concluded that in the present work, ACPB ingestion
was the major source of aluminium deposition in bones of patients with CRF rather than the water
used in dialysis or possible pollution of drinking water with aluminium in our province.
Description
Keywords
Chronic renal failure, Renal osteodystrophy, Aluminium intoxication, Aluminium bone disease (ABD)
Citation
Gupta Vijay, Verma Vijay, Gupta Rajesh k, Gandotra Dheeraj k, Mahajan Annil, Saini R K, Gupta V K, Dubey V K. The Spectrum of Renal Osteodystrophy: A Clinical, Biochemical, Radiological and Histopathological Study.JK Science Journal of Medical Education and Research. 2004 Jul-Sept;6(3): 138-143