Papers And Originals

Evolution of Bone Disease over 10 Years in 135 Patients with Terminal Renal Failure

Br Med J 1973; 4 doi: (Published 10 November 1973) Cite this as: Br Med J 1973;4:315
  1. G. L. V. Tatler,
  2. R. A. Baillod,
  3. Z. Varghese,
  4. W. B. Young S. Farrow,
  5. M. R. Wills,
  6. J. F. Moorhead


    An objective radiographic study of erosions, fractures, and periarticular and vascular calcification was made in a series of 135 patients over 10 years of maintenance haemodialysis therapy. The four lesions progressed at different rates, consistent with variation in the response of tissues to a changing biochemical milieu and deficiency in vitamin D metabolites. The half time for development of individual radiographic signs was 3·4 years for vascular calcification, 9 years for fractures, 16 years for periarticular calcification, and 22·9 years for erosions. Calcification of the dorsalis pedis artery seen as a developing ring or tube was an early and valuable sign of disturbed calcium metabolism. In these patients renal osteodystrophy is a chronic condition with a prolonged time course.