Skeletal changes in patients treated by regular haemodialysis in the Sheffield area

The incidence, type and degree of skeletal changes in 30 patients undergoing haemodialysis for chronic renal failure for over 18 months, are assessed by a radiological, clinical and biochemical study. This survey was also supported by bone biopsies in some of the cases. The main bone lesion was fracture. The fracture rate appeared to rise with the duration of haemodialysis. Osteosclerosis was noted in only one case and possibly was present in the pre-dialysis period while the appreciable decrease in bone density was seen in six patients. Fractures occurred more commonly in heavy patients with relatively high serum creatinine concentrations. Fractures were also commoner in patients who dialysed for long periods without a water softener and without taking oral calcium supplements.