Clinical Signs of Visser and van de Vyver for Aluminum-Induced Osteomalacia in a Patient with Severe Chronic Renal Failure

 

Clinical findings suggesting aluminum-induced osteomalacia - one or more of the following:

(1) presence of osteomalacia that fails to respond to adequate replacement with calcium and vitamin D

(2) borderline elevation of the serum calcium that rises sharply after administration of vitamin D

(3) serum iPTH (C terminal fragment) that is normal or slightly elevated, much lower than expected for the degree of renal failure

(4) hypercalcemia that persists after parathyroidectomy

(5) appearance of osteomalacia following parathyroidectomy

(6) serum alkaline phosphatase activity that is normal