Learning objectives
To understand the pathophysiology of musculoskeletal changes in patients with chronic kidney disease (CKD).
To be able to distinguish key imaging features related to different metabolic abnormalities in CKD.
Background
The prevalence of CKD in Europe differs by country, but it has been estimated that CKD affects about 11% of the European population with 1.0% - 5.9% suffering from advanced disease. CKD influences musculoskeletal system because of a crucial role of the kidneys in calcium/phosphorus metabolism [Fig.(1)1a]. Resultant disturbances are collectively known as CKD-Mineral and Bone Disease (CKD-MBD). These abnormalities reveal themselves clinically at G3-G5 CKD stages and are caused by either one or a combination of the following entities: abnormal metabolism of calcium and...
Findings and procedure details
DISTINCTIVE CKD-MBD CHANGES
SECONDARY AND TERTIARY HYPERPARATHYROIDISM
Predominant feature of HPT is an increased bone turnover with rapid bone resorption being its hallmark.
Bone resorption
several types of bone resorption are recognized [Tbl.1].
in 95% of patients with HPT, earliest and most typical skeletal changes develop in the hand -> hand radiographs are used both for confirmation of diagnosis and evaluation of treatment response
in the remaining 5%, the hands can be normal, while initial features of bone resorption will be present in other skeletal...
Conclusion
The knowledge of typical musculoskeletal complications of CKD enables their early identification and prompt treatment, reducing the risk of significant disability
Personal information and conflict of interest
M. N. Byrdy-Daca; Warsaw/PL - nothing to disclose P. Palczewski; Warsaw/PL - nothing to disclose M. Owczarek; Warsaw/PL - nothing to disclose M. Gołębiowski; Warsaw/PL - nothing to disclose
References
K. C. Abbott et al., Maintenance Immunosuppression Use and the Associated Risk of Avascular Necrosis After Kidney Transplantation in the United States, Transplantation 2005;79(3):330-336
A. M. Altman, S. M. Sprague, Mineral and Bone Disease in Kidney Transplant Recipients, Current Osteoporosis Reports 2018,16:703–711.
P. Gajewski et al., Interna Szczeklika, Medycyna Praktyczna, Kraków 2012,1208-1216;1407-1416.
A. Kramer et al., European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2016: a summary, Clinical Kidney Journal 2019,1-19.
M. D. Murphey et al., From the Radiologic Pathology Archives Imaging of Osteonecrosis:...