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  • Title: Osteomalacia and insufficiency fracture in a hemodialysis patient with autosomal dominant polycystic kidney disease.
    Author: Hiramatsu R, Ubara Y, Suwabe T, Sumida K, Hayami N, Yamanouchi M, Mise K, Hasegawa E, Hoshino J, Sawa N, Takaichi K.
    Journal: Intern Med; 2012; 51(23):3277-80. PubMed ID: 23207124.
    Abstract:
    A 61-year-old Japanese woman on hemodialysis with autosomal dominant polycystic kidney disease (ADPKD) was admitted to the hospital with gluteal pain. Radiographs demonstrated a fracture of the left pubis. The serum 1,25(OH)(2)-vitamin D and 25(OH)-vitamin D levels were low. A biopsy of the right iliac crest disclosed osteomalacia. Active vitamin D sterol was administered in conjunction with dietary modification. Her gluteal pain was resolved three years later, and healing of the fracture was confirmed by radiology. This case emphasizes that vitamin D deficiency and malnutrition can cause osteomalacia in dialysis patients, even if calcium (Ca) and phosphate (P) levels are controlled by calcium carbonate.
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