What is renal bone disease?

Healthy bones are constantly growing and changing. To keep your bones strong, your kidneys must keep the right balance of several important substances. These include phosphorus, calcium, parathyroid hormone, and vitamin D.

When you have chronic kidney disease, your body no longer keeps the right balance of these substances. This can lead to bone disease. When bone disease is caused by kidney problems, it is called renal bone disease.

Renal bone disease is called a "silent disease" because the bone changes begin long before symptoms occur. As renal bone disease gets worse, you may have:

• Calcium deposits in the blood vessels, which may lead to heart disease.
• Itchy skin.
• Pain in your bones and joints.
• Weak muscles.
• Broken bones.
• Crooked bones or short height in children.

By working with your doctor, you can take steps to reduce your chance of having weak or broken bones.

• If you don't have renal bone disease, take steps to avoid it.
  • Get regular exercise, which can help keep your bones strong.
  • Get the right amount of phosphorus, calcium, and vitamin D. Follow the diet your doctor or dietitian gives you.
• If you have renal bone disease, take steps to treat it. For example, you may need to:
  • Eat a diet that is low in phosphorus. A dietitian can help you make an eating plan that is low in phosphorus. You may need to:
    • Limit dairy products, such as milk, yogurt, or ice cream.
    • Avoid nuts, peanut butter, seeds, lentils, peas, and beans.
    • Avoid drinks such as beer, cola, and cocoa.
  • Take a medicine called a phosphate binder. A phosphate binder helps control the level of phosphorus in your blood.
  • Take vitamin D and calcium pills.
  • Take medicine to control your parathyroid glands. In some cases, these glands need to be removed by a surgeon.
  • Exercise to strengthen your bones. To make sure that an exercise program is safe for you, talk to your doctor before you begin.
• If you have renal bone disease, work closely with your doctor, have regular testing, and follow all treatment steps. Your doctor can advise you about how often you need testing. If you are on dialysis, you will probably be tested every 6 months.