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Renal osteodystrophy

Case contributed by Eric F Greif
Diagnosis almost certain

Presentation

Past medical history of end-stage renal disease on hemodialysis. History of renal transplant which eventually failed

Patient Data

Age: 75 years
Gender: Male
ct

There is severe bilateral renal atrophy consistent with patients known end-stage renal disease. Within the left pelvis, there is a transplanted kidney demonstrating small intrarenal calculi and cysts. The spine has diffuse heterogenous osteosclerotic changes. Differentials include metastatic (such as prostate CA), hematological (myelofibrosis), and metabolic disorders such as renal osteodystrophy. In this case with known renal disease and abnormal lab values, renal osteodystrophy was placed first on the differential list. 

Case Discussion

Past medical history of end-stage renal disease on hemodialysis three times a week. History of renal transplant, which eventually failed. Lab values demonstrated hyperphosphatemia.

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