Renal osteopathy is a disease associated with chronic weakness in kidney function. The disease is sometimes referred to by the synonymous term ‘renal osteodystrophy’ among medical professionals. Renal osteopathy is characterized by the fact that the affected patients suffer from skeletal disorders. In addition, the metabolism of minerals is impaired and does not function as in healthy individuals.
What is renal osteopathy?
In the context of renal osteopathy, what is known as osteomalacia develops in the bones. For what does mcs stand for, please visit biotionary.com.
There is a direct connection between an existing chronic kidney weakness and the occurrence of the symptoms.
Osteomalacia develops primarily as a result of hyperparathyroidism of a secondary nature.
Causes
The causes of renal osteopathy are very specific. The disease is primarily caused by secondary hyperparathyroidism. This is accompanied by electrolyte disturbances, and there is also a disturbance in the metabolism of vitamin D. On the one hand, the disease is characterized by impairments of the bones that are very similar to those of osteomalacia.
On the other hand, a so-called fibroosteoclasia usually develops, which can be attributed to the effect of the parathyroid hormones. In the context of chronic kidney weakness, the human organism lacks the substance calcitriol. This substance is a form of vitamin D that is active in the relevant metabolic process.
First, the hydroxylation of cholecalciferol occurs in the liver and kidney. Finally, the substance is converted to its biologically active state. Basically, calcitriol has the task of absorbing phosphate and calcium from the gastrointestinal tract and the kidneys.
This process is an important factor in the mineralization of bones. The absence of calcitriol initially leads to hypocalcaemia and later to osteomalacia or osteopathy.
Symptoms, Ailments & Signs
Renal osteopathy brings with it numerous different symptoms and complaints for the affected patients. Typically, the disease causes pain in the bones and joints, for example, and swollen and deformed areas are also possible. Sometimes the sick people suffer from a special form of muscle weakness.
In principle, renal osteopathy is a complicated disease of the bones or skeleton. Since dialysis is often carried out over many years in the case of existing kidney weakness, the disease occurs more frequently than in the past. Renal osteopathy is associated with an increased risk of bone fractures and muscle atrophy.
In the area of the shoulder joints, toes, knees and elbows, accumulations of calcium can sometimes be seen in renal osteopathy. As a result, the patients suffer from intense pain, which also reduces their ability to move. Overall, the quality of life is significantly reduced.
In some cases, the calcification of the vessels is so pronounced that the consequences are reduced peripheral blood flow and arterial occlusive disease. This can also lead to necrosis of the fingers or toes. This often requires a so-called dilatation of the vessels and an operation.
Diagnosis & course of disease
At the first signs and typical symptoms of renal osteopathy, a suitable specialist should be consulted as soon as possible. It is also possible to first contact the family doctor, who will refer the affected patient to an appropriate specialist. A detailed anamnesis is indispensable for making the diagnosis of renal osteopathy.
During the patient consultation, the person describes to the specialist their complaints, significant lifestyle features, as well as chronic and past diseases. This allows a suspected diagnosis to be made. In the second step, the doctor examines the clinical symptoms of the disease.
Various examination methods are also used, which facilitate a diagnosis of renal osteopathy. For example, various laboratory tests are indicated. Blood analyzes show concentrations of urea and creatinine that are higher than normal.
The results also usually indicate hyperphosphatemia. The levels of calcium in the serum of the blood are often very low, but may still be within the normal range. In addition to blood tests, imaging methods are usually used to diagnose renal osteopathy. When carrying out X-ray examinations, there are indications of what is known as osteitis fibrosa, which arises as a result of hyperparathyroidism.
Other typical findings are patchy osteosclerosis and subperiosteal resorptions. Occasionally, diffuse deformities develop in the bones, which also occur in primary hyperparathyroidism. These occur, for example, in the pelvic area.
Calcifications of an extraosseous nature, which form in particular within vessels, are also possible. If renal osteopathy occurs in childhood, there are disorders in the growth plates of the bones.
Complications
Renal osteopathy is already a complication of renal insufficiency, which is characterized by a complex bone disease. In addition to bone pain, deformation and swelling, there is also increased bone fragility. The brittleness of the bones often quickly leads to bone fractures, which often take a long time to heal. At the same time, calcium deposits can be found in all joints.
Shoulder joints, knees, elbows, fingers or toes are affected. These calcium deposits cause severe joint pain and also lead to impaired mobility. As a result, the patient’s quality of life is often severely restricted. Chronic pain, permanent fractures and the severe restriction of movement can also lead to a variety of mental illnesses.
Those affected are then often no longer able to participate in social life and therefore often isolate themselves. In many cases, those affected suffer from depression. The risk of suicide increases. Arterial occlusive disease is a serious and life-threatening complication of renal osteopathy. This is caused by calcium deposits in the vessels. A particularly severe form of occlusive disease occurs here.
In addition to increasing pain when walking (intermittent claudication), toes and fingers often die off. Since the arteries that supply the heart and brain are usually narrowed, heart attacks or strokes can also occur. In advanced stages, life can often only be saved by amputating the dying body parts.
When should you go to the doctor?
This disease should always be treated by a doctor. Since the disease affects the skeleton and can lead to serious problems in everyday life, treatment should always be carried out early to avoid further compilations. A doctor should be consulted if the person concerned suffers from pain in the bones. This pain can occur relatively sporadically and have a very negative effect on the patient’s everyday life and quality of life.
As a rule, the joints are also affected by pain, so that strenuous activities or sporting activities can no longer be carried out easily. Permanent muscle weakness can also indicate this disease and should be examined by a doctor. Patients are often at high risk of fractures or muscle damage. Disturbed blood circulation also points to renal osteopathy.
First and foremost, a general practitioner can be consulted. Further treatment depends on the exact severity of the complaints and symptoms and is carried out by a specialist.
Treatment & Therapy
The aim of treatment in renal osteopathy is primarily to normalize the concentrations of phosphate and calcium. Vitamin D in a special form must be administered urgently. Calcitriol and calcium carbonate are also substituted.
Prevention
Concrete measures to prevent renal osteopathy are not known. Rather, rapid, adequate therapy is indicated.
Aftercare
Depending on the severity of the skeletal symptoms and the kidney function, follow-up care is also necessary after treatment of renal osteopathy. Since the recovery of renal osteopathy depends largely on the nutrient levels in the blood, it is important to check them regularly. The blood levels of vitamin D, calcium, potassium and magnesium should be checked regularly by the doctor treating you.
If a deficiency is found, it must be remedied with appropriate food supplements or infusions. Since poor kidney function and accompanying dialysis are the cause of the mineral deficiency and the development of renal osteopathy, the kidney and urea levels in the blood must also be checked regularly.
In addition, nutrients should always be supplied via dietary supplements and/or infusions after dialysis has taken place. In addition to this, it is important for the aftercare of renal osteopathy to treat sequelae that have already occurred separately. This applies in particular to finger or toe necrosis, muscle weakness, bone deformation and arterial occlusive disease that have arisen as a result of renal osteopathy.
Blood-thinning medication (Macumar) is used to treat arterial disease. The Quick and INR values in the blood must be checked regularly. The appropriate treatment for necrosis, muscle weakness and bone deformities should be discussed with the doctor treating you, as not all treatments are suitable depending on kidney function.
You can do that yourself
Since renal osteopathy is an extremely complex clinical picture, the treatment methods must be individually adapted to the patient. Currently, treatments are only carried out symptomatically. But it is precisely here that there are various possibilities to use alternative therapy methods in addition to medical care. After prior professional instruction, these can be used at home and integrated into everyday life.
Such a measure can be the implementation of physical exercises. Various studies have proven the effectiveness of therapy for bone problems in renal osteopathy. Exercises that are adapted to the patient’s level of performance can promote the maintenance of mobility and performance. Yoga and gymnastics, for example, have not only a physiological but also a mental effect on the practitioner. Stress and fears associated with the consequences of the disease and life with the symptoms can be reduced. However, it is important to use these exercises regularly and to adapt the requirements to the respective course of the disease.
The positive effect on the patient through a functioning social network should also not be ignored. Friends and relatives can help to find new courage in life despite a serious illness.
