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Classification of Sherrad et al for Histologic Changes in Bone Seen with Renal Osteodystrophy

Description

Sherrard et al classified histologic changes seen in bone from patients with renal osteodystrophy. The histologic changes can help to identify what is happening in a particular patient with severe renal failure. The authors are from the University of Washington in Seattle, the University of Toronto and Massachusetts General Hospital in Boston.


 

Examination: morphometry is required for accurate measurement

 

Parameters:

(1) fibrosis as percent of tissue area

(2) osteoid (unmineralized bone) as a percent of total bone area

(3) bone formation rate in square microns per square mm tissue area per day

Fibrosis

Osteoid

Bone Formation

Process

0%

1 - 7%

108 - 500

normal

<= 0.5%

< 15%

>= 108

mild hyperpara-thyroidism

<= 0.5%

< 15%

< 108

aplastic/adynamic

> 0.5%

< 15%

NA

osteitis fibrosis

(severe hyper-parathyroidism)

<= 0.5%

>= 15%

NA

osteomalacia

> 0.5%

>= 15%

NA

mixed

 

where:

• 1 square millimeter (mm) is 1,000,000 square microns.

• The original table did not have equal signs for fibrosis or osteoid.

 


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