Parathyroid Disease in Long-Term Maintenance Hemodialysis

Bone disease is a frequent and potentially serious complication of chronic renal failure, particularly in patients undergoing long-term hemodialysis.^1,2 Correct diagnosis and adequate therapy initiated promptly are necessary for successful clinical results. An extensive discussion of the problem of bone disease in chronic renal failure will not be attempted here, since Stanbury has recently published an excellent review of this subject.³ He divided renal bone disease into two categories, the first of which is osteomalacia, or rickets, and is characterized by defective bone mineralization. The bone in this condition is made up of excessive osteoid which has not been properly mineralized and is thought to be in the early stage of renal bone disease which is treatable with vitamin D. The second, and more serious, category of bone disease has been called "osteitis fibrosa" because of its similarity to the osteitis fibrosa of primary hyperparathyroidism. This is