Management of renal osteodystrophy with 1,25(OH)₂D₃. II. Effects on histopathology of bone: Evidence for healing of osteomalacia

The effects of 6 months of therapy with 1,25(OH)₂D₃ on bone histology were evaluated in 12 dialysis patients. They all displayed evidence of bone disease consisting of osteitis fibrosa and osteomalacia of varying degrees and predominance. Therapy with 1,25-(OH)₂D₃ was associated with: decrease in osteoclastic activity; reduction or disappearance of endosteal fibrosis; - this improvement was independent of changes in serum iPTH levels; decrease in woven osteoid; decrease or normalization of osteoid volume, and normalization of bone mineralization. The data indicate that long-term therapy with 1,25(OH)₂D₃ can improve hyperparathyroid bone disease, restore bone architecture and heal osteomalacia.