Which of the following biochemical abnormality help to differentiate renal osteodystrophy from nutritional and genetic forms of osteomalacia?
Renal osteodystrophy is a metabolic condition associated with chronic renal failure. In renal insufficiency there is decreased excretion of phosphate leading to hyperphosphatemia. This in turn reduces the serum calcium and cause secondary hyperparathyroidism. Reduced synthesis of vitamin D secondary to chronic renal failure can also lead to hypocalcemia. Biochemical abnormality in renal osteodystrophy are hypocalcemia, hyperphosphatemia, increased alkaline phosphatase, hyper-parathyroidism, normal serum 25(OH)D. Boichemical abnormalities in osteomalacia includes normal or hypocalcemia, normal or hypophosphatemia, increased alkaline phosphatase, increased PTH, decreased serum 25(OH)D. Ref: Davidson's Principles and Practice of Medicine, 19th Edition, Page 973, Table 20.8; Ohopedic Nuclear Medicine By Abdelhamid H. Elgazzar, Page 86
Hypocalcaemia
Hypercalcemia
Hypophostaemia
Hyerphosphatema