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Bone biopsy and the diagnosis of renal osteodystrophy

L Darryl Quarles, MD
Section Editor
Jeffrey S Berns, MD
Deputy Editor
Alice M Sheridan, MD


Bone biopsy and histological evaluation of tetracycline-labeled bone is required for accurate stratification of bone diseases in chronic kidney disease (CKD). The indications for when to perform a bone biopsy and whether bone imaging and biomarkers can supplant histological assessment of bone are not clear.

There are five major types of bone disease that occur in patients with advanced chronic renal failure [1-4]:

Predominant hyperparathyroid-mediated high-turnover bone disease (osteitis fibrosa [OF])

Low-turnover osteomalacia (defective mineralization in association with low osteoclast and osteoblast activities)

Mixed uremic osteodystrophy (MUO; hyperparathyroid bone disease with a superimposed mineralization defect)


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Literature review current through: Sep 2016. | This topic last updated: Dec 21, 2015.
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