If the kidneys are damaged, there are not only disturbances in the metabolism of minerals. Hormonal balance is also out of balance. This is how the parathyroid glands produce excess parathyroid hormone. Too much of the hormone promotes bone loss. It also increases the level of phosphate in the blood, which can contribute to calcium deposits in the vessels. The factors mentioned mean that almost no calcium is incorporated into the bones and the bones are also affected by increased demineralization. The bones become softer and softer and lose stability.
What does renal osteopathy do to bone?
It is not only the risk of bone fractures, sometimes spontaneous, that increases. Bone softening (osteomalacia), bone loss (osteoporosis) and muscle weakness are also possible consequences of diseased kidneys. “Limited kidney function and the related reduced absorption of calcium from the blood into the bones can also lead to increased calcium deposits that form around the joints. These can cause pain in those affected and lead to limited movement and deformity,” he says. Ketteler.
Diseased kidneys not only weaken the bones
And weak kidneys present another risk: in advanced kidney failure, calcium deposits can form in the arteries and joints. These are made from calcium phosphate crystals. People with pronounced kidney weakness have a high risk of developing arteriosclerosis, i.e. hardening of the arteries. Calcified arteries are, among other things, a significant risk factor for heart attack, myocardial failure, narrowing of the heart valves and stroke.
Prof. Doctor Markus Kettelerhead of general internal medicine and nephrology / geriatrics at the Robert Bosch hospital in Stuttgart and chairman of the commission of the German Society of Nephrology (DgfN).
Treatment of renal osteopathy: balancing of mineral metabolism
Since weakened bones do not give warning signals, blood values are regularly checked for kidney failure and high doses of vitamin D3 are given as a preventative measure. “In this way, the development of renal osteopathy can be delayed or progress can be slowed,” says the nephrologist. “Medicines that inhibit the formation of parathyroid hormone can also be used. There are also preparations that bind phosphate that is ingested through food.” Consequential diseases of the bones and joints are treated separately. Among other things, some pain relievers and anti-inflammatory drugs are used.
Can a kidney transplant cure kidney osteopathy?
For many dialysis-dependent kidney patients, a kidney transplant is the great hope. It is not possible to predict how renal osteopathy will develop with the new kidney. According to the expert, pronounced osteopathy usually persists even after a kidney transplant. If, on the other hand, renal osteopathy was well under control before the transplant, a significant improvement can be hoped for. But after the transplant, the bones are in danger again: cortisone is administered to prevent the organ from being rejected. Cortisone significantly increases the risk of osteoporosis.