• 1
    Prevalence of chronic kidney disease and associated risk factors—United States, 1999–2004. MMWR Morb Mortal Wkly Rep. 2007; 56: 161165.
  • 2
    Thomas R, Kanso A, Sedor JR. Chronic kidney disease and its complications. Prim Care. 2008; 35: 329344.
  • 3
    Andress DL. Vitamin D treatment in chronic kidney disease. Semin Dial. 2005; 18: 315321.
  • 4
    Sanchez CP, Goodman WG, Salusky IB. Prevention of renal osteodystrophy in predialysis patients. Am J Med Sci. 1999; 317: 398404.
  • 5
    González EA, Sachdeva A, Oliver DA, Martin KJ. Vitamin D insufficiency and deficiency in chronic kidney disease. A single center observational study. Am J Nephrol. 2004; 24: 503510.
  • 6
    Coburn JW, Norris KC, Nebeker HG. Osteomalacia and bone disease arising from aluminum. Semin Nephrol. 1986; 6: 6889.
  • 7
    Gabriel R. Morbidity and mortality of long-term haemodialysis: a review. J R Soc Med. 1984; 77: 595601.
  • 8
    Piraino BM, Rault R, Dominguez JH, Puschett JB. Renal osteodystrophy in patients on hemodialysis for more than 10 years. Miner Electrolyte Metab. 1986; 12: 390396.
  • 9
    Mittalhenkle A, Gillen DL, Stehman-Breen CO. Increased risk of mortality associated with hip fracture in the dialysis population. Am J Kidney Dis. 2004; 44: 672679.
  • 10
    Nickolas TL, Leonard MB, Shane E. Chronic kidney disease and bone fracture: a growing concern. Kidney Int. 2008; 74: 721731.
  • 11
    Alem AM, Sherrard DJ, Gillen DL, et al. Increased risk of hip fracture among patients with end-stage renal disease. Kidney Int. 2000; 58: 396399.
  • 12
    Ball AM, Gilllen DL, Sherrard DJ, et al. Risk of hip fracture among dialysis and renal transplant recipients. JAMA. 2002; 288: 30143018.
  • 13
    Kanis JA, Johnell O, De Laet C, et al. International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res. 2002; 17: 12371244.
  • 14
    Stehman-Breen CO, Sherrard DJ, Alem AM, et al. Risk factors for hip fracture among patients with end-stage renal disease. Kidney Int. 2000; 58: 22002205.
  • 15
    Tejwani NC, Schachter AK, Immerman I, Achan P. Renal osteodystrophy. J Am Acad Orthop Surg. 2006; 14: 303311.
  • 16
    Ritz E, Merke DJ, Lukas PA. Genesis of bone disease in uremia. In: PeckWA, ed. Bone in Mineral Research. 5th ed. Amsterdam, The Netherlands: Elsevier; 1987: 309374.
  • 17
    Hamdy NA, Kanis JA, Beneton MN, et al. Effect of alfacalcidol on natural course of renal bone disease in mild to moderate renal failure. BMJ. 1995; 310: 358363.
  • 18
    Moe S, Drüeke T, Cunningham J, et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006; 69: 19451953.
  • 19
    Coco M, Rush H. Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone. Am J Kidney Dis. 2000; 36: 11151121.
  • 20
    DeVita MV, Rasenas LL, Bansal M, et al. Assessment of renal osteodystrophy in hemodialysis patients. Medicine (Baltimore). 1992; 71: 284290.
  • 21
    Fletcher S, Jones RG, Rayner HC, et al. Assessment of renal osteodystrophy in dialysis patients: use of bone alkaline phosphatase, bone mineral density and parathyroid ultrasound in comparison with bone histology. Nephron. 1997; 75: 412419.
  • 22
    Jüppner H, Potts Jr JT. Immunoassays for the detection of parathyroid hormone. J Bone Miner Res. 2002; 17(Suppl 2): N81N86.
  • 23
    Friedman PA. PTH revisited. Kidney Int Suppl. 2004; 91: S13S19.
  • 24
    Martin KJ, Olgaard K, Coburn JW, et al. Diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy. Am J Kidney Dis. 2004; 43: 558565.
  • 25
    Souberbielle JC, Friedlander G, Cormier C. Practical considerations in PTH testing. Clin Chim Acta. 2006; 366: 8189.
  • 26
    Negri AL, Alvarez Quiroga M, Bravo M, et al. [Whole PTH and 1-84/84 PTH ratio for the non invasive determination of low bone turnover in renal osteodysthrophy]. Nefrologia. 2003; 23: 327332.
  • 27
    Gal-Moscovici A, Popovtzer MM. New worldwide trends in presentation of renal osteodystrophy and its relationship to parathyroid hormone levels. Clin Nephrol. 2005; 63: 284289.
  • 28
    K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease. Available at:
  • 29
    Sawaya BP, Butros R, Naqvi S, et al. Differences in bone turnover and intact PTH levels between African American and Caucasian patients with end-stage renal disease. Kidney Int. 2003; 64: 737742.
  • 30
    Sawaya BP, Monier-Faugere MC, Ratanapanichkich P, et al. Racial differences in parathyroid hormone levels in patients with secondary hyperparathyroidism. Clin Nephrol. 2002; 57: 5155.
  • 31
    Sprague SM. The role of the bone biopsy in the diagnosis of renal osteodystrophy. Semin Dial. 2000; 13: 152155.
  • 32
    Urena P, De Vernejoul MC. Circulating biochemical markers of bone remodeling in uremic patients. Kidney Int. 1999; 55: 21412156.
  • 33
    Ureña P, Hruby M, Ferreira A, et al. Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. J Am Soc Nephrol. 1996; 7: 506512.
  • 34
    Taylor AK, Leuken SA, Libanati C, Baylink DJ. Biochemical markers of bone turnover for the clinical assessment of bone metabolism. Rheum Dis Clin North Am. 1994; 20: 589607.
  • 35
    Mazzaferro S, Pasquali M, Ballanti P, et al. Diagnostic value of serum peptides of collagen synthesis and degradation in dialysis renal osteodystrophy. Nephrol Dial Transplant. 1995; 10: 5258.
  • 36
    Ureña P, Ferreira A, Kung VT, et al. Serum pyridinoline as a specific marker of collagen breakdown and bone metabolism in hemodialysis patients. J Bone Miner Res. 1995; 10: 932939.
  • 37
    Yamaguchi T, Kanno E, Tsubota J, et al. Retrospective study on the usefulness of radius and lumbar bone density in the separation of hemodialysis patients with fractures from those without fractures. Bone. 1996; 19: 549555.
  • 38
    Ureã P, Bernard-Poenaru O, Ostertag A, et al. Bone mineral density, biochemical markers and skeletal fractures in haemodialysis patients. Nephrol Dial Transplant. 2003; 18: 23252331.
  • 39
    Rix M, Andreassen H, Eskilden P, Langdahl B, Olgaard K, et al. Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure. Kidney Int. 1999; 56: 10841093.
  • 40
    Pecovnik Balon B, Bren A. Bone histomorphometry is still the golden standard for diagnosing renal osteodystrophy. Clin Nephrol. 2000; 54: 463469.
  • 41
    Chazan JA, Libbey NP, London MR, et al. The clinical spectrum of renal osteodystrophy in 57 chronic hemodialysis patients: a correlation between biochemical parameters and bone pathology findings. Clin Nephrol. 1991; 35: 7885.
  • 42
    Hercz G, Pei Y, Greenwood C, et al. Aplastic osteodystrophy without aluminum: the role of “suppressed” parathyroid function. Kidney Int. 1993; 44: 860866.
  • 43
    Goodman WG, Ramirez JA, Belin TR, et al. Development of adynamic bone in patients with secondary hyperparathyroidism after intermittent calcitriol therapy. Kidney Int. 1994; 46: 11601166.
  • 44
    Torres A, Lorenzo V, Hernández D, et al. Bone disease in predialysis, hemodialysis, and CAPD patients: evidence of a better bone response to PTH. Kidney Int. 1995; 47: 14341442.
  • 45
    Coen G, Ballanti P, Bonucci E, et al. Bone markers in the diagnosis of low turnover osteodystrophy in haemodialysis patients. Nephrol Dial Transplant. 1998; 13: 22942302.
  • 46
    Velasquez Forero F, Altamirano E, Ramos PT. High frequency of iron bone deposits in a Mexican population with renal osteodystrophy. Nephrol Dial Transplant. 1998; 13(Suppl 3): 4650.
  • 47
    Olaizola I, Aznarez A, Jorgetti V, et al. Are there any differences in the parathyroid response in the different types of renal osteodystrophy? Nephrol Dial Transplant. 1998; 13(Suppl 3): 1518.
  • 48
    D'Haese PC, Couttenye MM, Lamberts LV, et al. Aluminum, iron, lead, cadmium, copper, zinc, chromium, magnesium, strontium, and calcium content in bone of end-stage renal failure patients. Clin Chem. 1999; 15: 15481556.
  • 49
    Gerakis A, Hadjidakis D, Kokkinakis E, et al. Correlation of bone mineral density with the histological findings of renal osteodystrophy in patients on hemodialysis. J Nephrol. 2000; 13: 437443.
  • 50
    Carmen Sánchez M, et al. Parathormone secretion in peritoneal dialysis patients with adynamic bone disease. Am J Kidney Dis. 2000; 36: 953961.
  • 51
    Jarava C, Armas JR, Palma A. [Study of renal osteodystrophy by bone biopsy. Age as an independent factor. Diagnostic value of bone remodeling markers]. Nefrologia. 2000; 20: 362372.
  • 52
    Changsirikulchai S, Domrongkitchaiporn S, Sirikulchayanonta V, et al. Renal osteodystrophy in Ramathibodi Hospital: histomorphometry and clinical correlation. J Med Assoc Thai. 2000; 83: 12231232.
  • 53
    Ballanti P, Coen G, Mazzaferro S, et al. Histomorphometric assessment of bone turnover in uraemic patients: comparison between activation frequency and bone formation rate. Histopathology. 2001; 38: 571583.
  • 54
    Monier-Faugere MC, Geng Z, Mawad H, et al. Improved assessment of bone turnover by the PTH-(1-84)/large C-PTH fragments ratio in ESRD patients. Kidney Int. 2001; 60: 14601468.
  • 55
    Coen G, Ballanti P, Balducci A, et al. Serum osteoprotegerin and renal osteodystrophy. Nephrol Dial Transplant. 2002; 17: 233238.
  • 56
    Chu P, Chao TY, Lin YF, et al. Correlation between histomorphometric parameters of bone resorption and serum type 5b tartrate-resistant acid phosphatase in uremic patients on maintenance hemodialysis. Am J Kidney Dis. 2003; 41: 10521059.
  • 57
    Ng AH, Hercz G, Kandel R, Grynpas MD. Association between fl uoride, magnesium, aluminum and bone quality in renal osteodystrophy. Bone. 2004; 34: 216224.
  • 58
    Coen G, Mantella D, Manni M, et al. 25-Hydroxyvitamin D levels and bone histomorphometry in hemodialysis renal osteodystrophy. Kidney Int. 2005; 68: 18401848.
  • 59
    Coen G, Ballanti P, Balducci A, et al. Renal osteodystrophy: alpha-Heremans Schmid glycoprotein/ fetuin-A, matrix GLA protein serum levels, and bone histomorphometry. Am J Kidney Dis. 2006; 48: 106113.
  • 60
    Van Eps CL, Jeffries JK, Anderson JA, et al. Mineral metabolism, bone histomorphometry and vascular calcification in alternate night nocturnal haemodialysis. Nephrology (Carlton). 2007; 12: 224233.
  • 61
    Barreto FC, Barreto DV, Moysés RM, et al. K/DOQIrecommended intact PTH levels do not prevent lowturnover bone disease in hemodialysis patients. Kidney Int. 2008; 73: 771777.
  • 62
    Mora Palma FJ, Ellis HA, Cook DB, et al. Osteomalacia in patients with chronic renal failure before dialysis or transplantation. Q J Med. 1983; 52: 332348.
  • 63
    Lindenau K, Kokot F, Vetter K, et al. Current status of diagnosis and treatment of renal osteodystrophy in the predialysis period. Contrib Nephrol. 1988; 6510765114.
  • 64
    Lorenzo Sellares V, Torres Ramírez A, Hernández Marrero D, et al. [A study using nondecalcified bone biopsy of the incidence and presentation forms of renal osteodystrophy]. Med Clin (Barc). 1991; 96: 561565.
  • 65
    Hutchison AJ, Whitehouse RW, Boulton HF, et al. Correlation of bone histology with parathyroid hormone, vitamin D3, and radiology in end-stage renal disease. Kidney Int. 1993; 44: 10711077.
  • 66
    Sato T. [Studies on the pathogenesis and pathophysiology of renal osteodystrophy. II. Bone histology of chronic renal failure patients at the time of starting hemodialysis]. Nippon Jinzo Gakkai Shi. 1994; 36: 11451158.
  • 67
    Coen G, Mazzaferro S, Ballanti P, et al. Renal bone disease in 76 patients with varying degrees of predialysis chronic renal failure: a cross-sectional study. Nephrol Dial Transplant. 1996; 11: 813819.
  • 68
    Lafage-Proust MH, Combe C, Barthe N, Aparicio M. Bone mass and dynamic parathyroid function according to bone histology in nondialyzed uremic patients after long-term protein and phosphorus restriction. J Clin Endocrinol Metab. 1999; 84: 512519.
  • 69
    Coen G, Ballanti P, Bonucci E, et al. Renal osteodystrophy in predialysis and hemodialysis patients: comparison of histologic patterns and diagnostic predictivity of intact PTH. Nephron. 2002; 91: 103111.
  • 70
    Douthat WG, Garay G, de Arteaga J, et al. [Biochemical and histological spectrum of renal osteodystrophy in Argentina]. Nefrologia. 2003; 23(Suppl 2): 4751.
  • 71
    Spasovski GB, Bervoets AR, Behets GJ, et al. Spectrum of renal bone disease in end-stage renal failure patients not yet on dialysis. Nephrol Dial Transplant. 2003; 18: 11591166.
  • 72
    Bervoets AR, Spasovski GB, Behets GJ, et al. Useful biochemical markers for diagnosing renal osteodystrophy in predialysis end-stage renal failure patients. Am J Kidney Dis. 2003; 41: 9971007.
  • 73
    Lobão R, Carvalho AB, Cuppari L, et al. High prevalence of low bone mineral density in pre-dialysis chronic kidney disease patients: bone histomorphometric analysis. Clin Nephrol. 2004; 62: 432439.
  • 74
    Lehmann G, Stein G, Hüller M, et al. Specific measurement of PTH (1-84) in various forms of renal osteodystrophy (ROD) as assessed by bone histomorphometry. Kidney Int. 2005; 68: 12061214.