ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2017
Fractures and Osteomalacia in a Patient Treated With Frequent Home Hemodialysis.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Renal Association Clinical Practice Guideline on Haemodialysis.BMC nephrology · 2019Guideline
- Chronic kidney disease: from mineral dysregulation to bone and cardiovascular disease.Journal of endocrinological investigation · 2026Review
- Personalized nutrition in haemodialysis: a scoping review of studies published between 2015 and 2025.Clinical kidney journal · 2026Review
- Evaluating Osteoporosis in Chronic Kidney Disease: Both Bone Quantity and Quality Matter.Journal of clinical medicine · 2024Review
- End-stage renal disease increases risk of postoperative complications after lower extremity fracture.Archives of orthopaedic and trauma surgery · 2021Article
- Traditional and Non-traditional Risk Factors for Osteoporosis in CKD.Calcified tissue international · 2021Review
- Osteomalacia and Vitamin D Status: A Clinical Update 2020.JBMR plus · 2021Article
- Comparison of clinical, biochemical and histomorphometric analysis of bone biopsies in dialysis patients with and without fractures.Journal of bone and mineral metabolism · 2019Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
Bone deformities and fractures are common consequences of renal osteodystrophy in the dialysis population. Persistent hypophosphatemia may be observed with more frequent home hemodialysis regimens, but the specific effects on the skeleton are unknown. We present a patient with end-stage renal disease treated with frequent home hemodialysis who developed severe bone pain and multiple fractures, including a hip fracture and a tibia-fibula fracture complicated by nonunion, rendering her nonambulatory and wheelchair bound for more than a year. A bone biopsy revealed severe osteomalacia, likely secondary to chronic hypophosphatemia and hypocalcemia. Treatment changes included the addition of phosphate to the dialysate, a higher dialysate calcium concentration, and increased calcitriol dose. Several months later, the patient no longer required a wheelchair and was able to ambulate without pain. Repeat bone biopsy revealed marked improvements in bone mineralization and turnover parameters. Also, with increased dialysate phosphate and calcium concentrations, as well as increased calcitriol, circulating fibroblast growth factor 23 levels increased.
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