The objectives of an excellent symposium or workshop on a given medical problem are to furnish answers, create new insights, and stimulate future investigation. I feel that this meeting on osteodystrophy and divalent ion metabolism in chronic renal failure has fulfilled these objectives.
Every facet of the clinical spectrum of the disordered divalent ion and osseous metabolism, as it occurs in the stable, chronically uremic patient, those undergoing long-term hemodialysis, and following successful renal transplantation, has been presented to us. One has the strong impression that these clinical patterns represent the end result of a continuing process that begins in the earliest phase of renal disease. Unfortunately, the usual diagnostic procedures are not adequate to detect the abnormalities of calcium, phosphorus, and bone metabolism. Such studies as intestinal absorption of calcium determined by the balance or radioisotope technique, renal clearances of calcium and phosphorus, radioimmunoassay of circulating parathyroid hormone, responsiveness