Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Osteomalacia and Insufficiency Fracture in a Hemodialysis Patient with Autosomal Dominant Polycystic Kidney Disease
Rikako HiramatsuYoshifumi UbaraTatsuya SuwabeKeiichi SumidaNoriko HayamiMasayuki YamanouchiKoki MiseEiko HasegawaJunichi HoshinoNaoki SawaKenmei Takaichi
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JOURNALS OPEN ACCESS

2012 Volume 51 Issue 23 Pages 3277-3280

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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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© 2012 by The Japanese Society of Internal Medicine
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