Definition and classification of renal osteodystrophy

One of the major complications that arise as a result of chronic kidney disease is that of ‘renal osteodystrophy.’ It is believed to be a multifactorial disorder of altered bone modeling. Bone biopsy occupies a central role in the differentiation of the various kinds of renal osteodystrophy based on histological findings. However, due to its limitations of being a rather invasive and costly procedure, it is performed rather infrequently. Therefore, scientists started to focus on alternative measures of classifying the various types, e.g., the parathyroid hormone (PTH). PTH has been used as an indicator of bone turnover, thereby dividing the diseases into those of high turnover and low turnover. To further our understanding of this particular disease entity, a unified definition and classification was formulated and adopted by well-renowned experts from both local and international scenes, and this is presented in some detail in this chapter. It is hoped, that such unification will enhance communication, facilitate clinical decision making, and promote the evolution of evidence-based clinical practice guidelines worldwide. (2)