How is Adynamic bone disease diagnosed?
Adynamic bone disease is characterized by a low-bone-turnover state. Bone biopsy remains the diagnostic gold standard for adynamic bone disease. Aggressive PTH suppression can increase the risk of this disease process.
What is adynamic bone disease?
Adynamic bone disease (ABD), a.k.a. aplastic lesion, is a histological condition found in uremic patients. It is characterized by low bone resorption and formation, and, in contrast to osteomalacia, the amount of osteoid tissue is normal or low.
What causes adynamic bone disease?
ABD develops in situations with reduced osteoanabolic stimulation caused by oversuppression of PTH, multifactorial skeletal resistance to PTH actions in uremia, and/or dysregulation of Wnt signaling. All may contribute not only to bone disease but also to the early vascular calcification processes observed in CKD.
How is Adynamic bone disease treated?
Adynamic bone is treated by increasing bone turnover through an increase in PTH. This can best be accomplished by lowering doses of calcium-based phosphate binders and vitamin D or entirely eliminating such therapy. The lowering of dialysate calcium (1.0 to 2.0 mEq/L) has also been suggested as a possible approach.
What does low bone turnover mean?
Low turnover disease or adynamic bone disease (ABD) is characterized by a low number of osteoblasts with normal or reduced numbers of osteoclasts. Mineralization proceeds at a normal rate, resulting in normal or decreased osteoid thickness.
What is CKD MBD?
Mineral Bone Disease (MBD) is a common problem in people with Chronic Kidney Disease (CKD) and affects almost all patients on dialysis. MBD leads to weakness in bones and blood vessel disease. MBD is caused by changes in blood levels of calcium and phosphate and hormonal changes.
What is a good CTX score?
Information on the serum CTX Test
| CTX Value | Risk for ONJ |
|---|---|
| 300 to600 pg/ml (normal) | none |
| 150 to 299 pg/ml | none to minimal |
| 101 to 149 pg/ml | moderate |
| Less than 100 pg/ml | high |
Is Stage 5 kidney disease the same as ESRD?
The difference between CKD Stage 5 and ESRD is the dependence on dialysis. A patient with CKD Stage 5 may or may not be on dialysis and the damage to the kidney may be reversible. A patient with the diagnosis of ESRD requires chronic dialysis.