The concept that osteomalacia becomes progressively worse on chronic dialysis was reinforced by the findings in the repeat bone biopsies in that 6 of the 8 patients showed a significant increase in their osteoid index. . . . Thus, the progression of osteomalacia appears to be the main reason for the increasing incidence of bone pain and pseudofractures which we and others have observed in patients on chronic dialysis for periods longer than 6 months. Jowsey, et al, has reported similar findings.
Enamel hypoplasia
The pathogenesis of this is that severe metabolic upset causes a permanent mark, called enamel hypoplasia, in the developing tooth which remains as a visible defect on the tooth throughout the life of the patient. The position and extent of the defect indicates the timing, duration and to some extent the severity of the underlying metabolic upset. Enamel hypoplasia is frequently seen in patients with renal disease, and has been attributed to the production of poorly-fo
