Renal Osteodystrophy

Replacement of the kidney's excretory function by dialysis has prolonged life, but it has also revealed the extent and importance of the organ's endocrine function. Lacking the kidney's endocrine contributions, patients undergoing long-term maintenance dialysis have considerable morbidity and mortality. Renal osteodystrophy, which is related to the diminished production of 1,25-dihydroxyvitamin D (1,25D), is one abnormality that results from the disturbed endocrine function of failing kidneys. Current research is attempting to unravel the pathogenetic events and underlying mechanisms of uremic osteodystrophy. These include, in addition to the increased excretion of phosphate per nephron and the impaired production of 1,25D, the . . .