Type:
Educational Exhibit
Keywords:
Musculoskeletal system, Kidney, Musculoskeletal, Thyroid / Parathyroids, CT, Digital radiography, Education, Education and training, Metabolic disorders, Transplantation, Not applicable, Performed at one institution
Authors:
M. N. Byrdy-Daca, M. Owczarek, P. D. Palczewski, M. Golebiowski; Warsaw/PL
DOI:
10.26044/ecr2020/C-15085
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 phosphorus, PTH secretion disorder, and vitamin D deficiency. [Fig.(2-3)1b-c]
In 2016, the incidence of renal replacement therapy (RRT) for end-stage renal disease in Europe was 121 per million population. The majority of patients (84%) started RRT with haemodialysis. In 2016, 22 046 Europeans underwent kidney transplantations. In kidney recipients, CKD-MBD most often manifests as low-turnover bone disease (50% of post-transplant bone biopsies), however high-turnover bone disease due to persistent hyperparathyroidism (HPT) is not rare (25–50%). Patients on RRT will show changes arising from amyloid deposition, aluminium intoxication, or adverse effects of immunosuppression [Fig. (4)1d].