Metabolic Studies of Bone in Uremia Before and After Treatment

Abstract To ascertain the frequency and severity of bone disease in terminal chronic renal failure and to evaluate the effects of chronic hemodialysis and renal transplantation upon it, bone biopsies have been obtained in 11 functionally anephric patients before and after treatment. The results of metabolic and histologic studies of the tissue obtained have been examined in the light of their clinical findings. These studies indicate that bone disease (often severe) is present in virtually all patients in the terminal phase of renal failure, even though clinical evidence of it may be absent; the metabolic changes present in the skeleton are characteristic of hyperparathyroidism, but evidence of osteomalacia can also be found by morphologic methods in most patients; and hemodialysis, even though apparently clinically effective, only rarely arrested or reversed the process, successful renal transplantation (or the immunosuppressive therapy that followed it) was the only therapy that appeared to have significant beneficial effects.