ABD Bone Biopsy Tetracycline Low Turnover — ESENeph MCQ

Correct answer: E — Adynamic bone disease associated with markedly suppressed bone turnover

The best answer is “Adynamic bone disease associated with markedly suppressed bone turnover”. Excess calcium loading, calcimimetic or active vitamin-D therapy can suppress PTH and bone formation; management reviews these drivers while avoiding rebound severe hyperparathyroidism. “Osteitis fibrosa associated with uncontrolled secondary hyperparathyroidism” is less appropriate because that is a high-turnover lesion associated with elevated PTH “Dialysis-related amyloidosis associated with beta-2-microglobulin deposition” is less appropriate because that causes periarticular amyloid and bone cysts rather than absent bone formation “Aluminium osteomalacia associated with substantial historical aluminium exposure” is less appropriate because the biochemical and treatment context instead supports PTH over-suppression “Osteoporosis associated with low density and relatively preserved bone turnover” is less appropriate because bone-turnover histology establishes a distinct renal osteodystrophy lesion

Reference: KDIGO 2017 CKD-MBD guideline update: https://kdigo.org/wp-content/uploads/2017/02/2017-KDIGO-CKD-MBD-GL-Update.pdf