Renale Osteodystrophie

Zusammenfassung

Chronische Nierenerkrankungen weisen eine zunehmende Inzidenz und Prävalenz auf und verursachen Komplikationen an verschiedenen Organsystemen. Die Veränderungen des Mineralstoffwechsels bei chronischer Niereninsuffizienz bedingen Störungen des kardiovaskulären Systems und des Knochenstoffwechsels mit den klinischen Endpunkten Myokardinfarkt/Schlaganfall und Fraktur und münden in eine gesteigerte Mortalität. Die renale Osteodystrophie ist ein Teil der CKD-MBD. Der Terminus „renale Osteodystrophie“ ist den histologischen Knochengewebsveränderungen vorbehalten und erfordert zur Charakterisierung eine Knochenbiopsie. Die internationale Klassifizierung unterscheidet 4 Formen: sekundärer Hyperparathyreoidismus, Osteomalazie, gemischte urämische Osteodystrophie und adyname renale Knochenerkrankung. Die nicht invasiven Untersuchungen entsprechen denen, die zur Diagnostik der Osteoporose eingesetzt werden. Das Spektrum der therapeutischen Optionen ist begrenzt.

Abstract

Impaired renal function causes disturbances in mineral and bone metabolism leading to bone fractures and calcification of soft tissues and blood vessels. Renal osteodystrophy – a component of the chronic kidney disease and mineral bone disorder (CKD-MBD) – can be differentiated by bone biopsy only. The international classification distinguishes 4 forms of renal osteodystrophy: hyperparathyroidism, osteomalacia, mixed uremic osteodystrophy and adynamic renal bone disease. Other diagnostic procedures correspond to those used in osteoporosis. Therapeutic options are limited.

Schlüsselwörter

CKD-MBD - renale Osteodystrophie - Knochenbiopsie - Histomorphometrie

Key words

CKD-MBD - renal osteodystrophy - bone biopsy - histomorphometry

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