Renal osteodystrophy

Renal osteodystrophy is defined as an alteration of bone in patients with chronic kidney disease (CKD). It is one measure of the skeletal component of the systemic disorder of chronic kidney disease-mineral and bone disorder (CKD-MBD). The term "renal osteodystrophy" was coined in 1943, 60 years after an association was identified between bone disease and kidney failure.

The types of renal osteodystrophy have traditionally been defined on the basis of bone turnover and mineralization:
1) mild, slight increase in turnover and normal mineralization;
2) osteitis fibrosa, increased turnover and normal mineralization;
3) osteomalacia, decreased turnover and abnormal mineralization;
4) adynamic, decreased turnover and acellularity; and,
5) mixed, increased turnover with abnormal mineralization.
A Kidney Disease: Improving Global Outcomes (KDIGO) report has suggested that bone biopsies in patients with CKD should be characterized by determining bone turnover, mineralization, and volume (TMV system).

On the other hand, CKD-MBD is defined as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of:
1) abnormalities of calcium, phosphorus, PTH, or vitamin D metabolism;
2) abnormalities in bone turnover, mineralization, volume, linear growth, or strength (renal osteodystrophy); and
3) vascular or other soft-tissue calcification.