Korean J Nephrol.  2005 Mar;24(2):332-336.

A Case Report of High-turnover Renal Osteodystrophy with Positive Aluminum Staining

• Kim SH
• Park YK
• Chang JW
• Lee EK
• Choi J
• Park SK

Abstract

Renal osteodystrophy is used to describe the diverse clinical spectrum and the various histologic bone abnormalities found in patients with chronic renal failure. Although asymptomatic, histologic bone abnormalities begin early in chronic renal failure. The principal types of histologic bone abnormalities observed in patients with chronic renal failure are a high-turnover bone disease associated with secondary hyperparathyroidism and the histologic picture of osteitis fibrosa and a low-turnover bone disease included osteomalacia and adynamic or aplastic bone disease and a mixed bone disease shared histologic evidence of high- and low-turnover bone disease. Bone biopsy is an invasive procedure that remains the only approach for definitive diagnosis of aluminum-related bone disease and the type and severity of renal osteodystrophy. Positive aluminum staining is found mainly patients with low-turnover bone disease. We experienced a case of high-turnover renal osteodystrophy associated with positive aluminum staining. After successful kidney transplantation, serial bone histological studies indicate that aluminum overload resolves and high-turnover renal osteodystrophy improves more slowly. Because aluminum is retained long periods at the tissue, we should keep in mind that even low-dose use of aluminum-based phosphate binders adds to the bone load in dialysis patients and has the risk of aluminum-related bone disease.

Keyword

Renal osteodystrophy; Aluminum; High-turnover bone disease

MeSH Terms

Aluminum*
Biopsy
Bone Diseases
Diagnosis
Dialysis
Humans
Hyperparathyroidism, Secondary
Kidney Failure, Chronic
Kidney Transplantation
Osteitis
Osteomalacia
Renal Osteodystrophy*
Aluminum