Severe maxillofacial renal osteodystrophy in two patients with chronic kidney disease

Abstract Renal osteodystrophy (ROD) is the bone pathology that occurs as an uncommon complication related to the several alterations inmineral metabolism present in patientswith chronic kidney disease (CKD). This paper describes two cases of severe ROD affecting the maxilla and mandible and causing facial disfigurement of a young and a middle-aged female patient with CKD. Both patients had a history of secondary hyperparathyroidism, previously treated by surgery. The pathogenesis of the disease, as well as its clinical, imaging, and histopathological features, and management of the patient are discussed. disorder (CKD-MBD), which involves changes in laboratory tests such as serum calcium, organic phosphate, parathyroid hormone (PTH), and concentrations of vitamin D derivatives; changes in bone turnover; and extraskeletal calcifications [3, 4]. Renal osteodystrophy (ROD) has recently been redefined to refer to the bone pathology from this syndrome [5]. Advancements in the knowledge about CKD and its complications, such as secondary hyperparathyroidism (HPT-II) and ROD, resulted in a decreased frequency of significant macroscopic bone al terations in kidney patients. Nonetheless, radiographic changes of the facial skeleton still eventually occur, occasionally involving the jaws, and may represent an early sign of ROD [6–8]. This manuscript reports the details of two unusually severe maxillofacial manifestations of ROD in patients with CKD, emphasizing the laboratorial, clinical, imaging, and histological features as well as patient management