The Manifestations of Bone Disease in Chronic Kidney Disease

Renal osteopathy is a common complication of chronic renal failure, also a part of mineral metabolic disturbance. It involve many organs especially the multisystem calcification. What are the manifestations of bone disease in chronic kidney disease?

● Bone ache and bone fracture
Bone ache might be persistent or paroxysmal. It can happen everywhere, involving in either the whole or one part of the body but it is more common in back, knee joint and leg. Workload, stress and exercise can worsen the pain. In severe cases, people have to lie in bed and even develop mutilation. Any type of bone disease will develop bone pain especially the chondrification disease.

● Arthritis
Arthritis can occur, manifesting red, swelling, hot and ache when secondary hyperparathyroidism, along with hyperphosphatemia present. Usually, people feel pain in the shoulders, knee, and articulationes. Symptoms get remission 1-2 weeks after parathyroid gland removal.

● Itching skin
It is a common symptom in end-stage renal disease which remits after ample dialysis is done. However, in some cases itching skin which did not response to any treatment profoundly affects the mood, sleep and normal life. The causes of itching skin are still unknown. The refractory itching might link to hyperparathyroidism. Parathyroid gland removal release s the symptoms.

● Skeletal deformity and delayed growth
Skeletal deformity is common in children and adults with end-stage renal failure and persistent HD. The following is a picture of people with skeletal deformity. In children, skeletal deformity brings delayed growth


● Myopathy and myasthemia
Generally, myopathy often occurs in the proximal musculi especially in the lower extremities. Myosthemia often slowly progressive and people have the difficulty in going upstairs. In severe cases, they cannot elevate the upper limbs. Too much high PTH levels and lack of phosphonium link to the myopathy.

● Other symptoms
PTH, a type of toxic substances in end-stage renal disease patients can cause damage of various organs.


The deposition of calcium in the cornea can cause eye disease. Anemia is related to the secondary hyperparathyroidism. Elevated PTH levels can cause epilepsy attack, aphrenia, heart failure, abnormal heart rate etc.