A patient with end-stage renal disease may develop adynamic bone disease (ABD), which can occur alone or mixed with other bone disorders constituting renal osteodystrophy. It appears to be related to a relative hypoparathyroidism.
Features of adynamic bone disease:
(1) low rate of bone formation with delayed mineralization
(2) low rate of bone turnover and remodeling
(3) decreased numbers of both osteoblasts and osteoclasts
(4) absence of increased osteoid (unmineralized bone) formation
(5) absence of fibrosis in the medullary spaces
(6) poor tetracycline uptake
Risk factors for adynamic bone disease:
(1) aluminum deposition
(2) advanced age
(3) diabetes mellitus
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