Osteogenic nephropathy

Osteogenic nephropathy (osteoarthropathy; from the Greek. osteon - bone, nephros - kidney and pathos - disease - the number of common diseases in which the most important is pathogenetically their connecting the combination of the two most affected systems - bone and kidney.
Damage to the kidneys in the form of excretory nephrosis and bilateral stones renal pelvis is found in certain pathological processes in the bones, accompanied by heavy resorption and bone tissue death. The most severe form of osteogenic nephropathy develop at parathyroid osteodystrophies (diseases of Recklinghausen), in multiple myeloma or metastatic tumors in the bones.
Not so hard kidneys are affected with chronic purulent osteomyelitis, repeated fractures.
With extensive resorption of bone, the blood receives a large number of salts of lime (hypercalcemia), which are derived mainly kidneys; this raises gipercalziuria. Lime salt in excess is excreted in the urine, may precipitate as in the tubular lumen and in the cavity of cups and pelvis. In the first case in the bone (mainly in direct) formed lime metastases in the form of lime cylinders, in the second, the conditions for the formation of stones. These conditions are fulfilled when in urine by renal appear dense particles, which is possible, for example, inflammation accompanied by release and the seal of the exudate, and with abundant introduction therapeutic purposes sulfa drugs, also standing out kidneys, fall into the pelvis in the form of crystals. In conditions of gipercalziurii dense particles become centers of lime precipitation of salts and give a start to the formation. In the years of the great Patriotic war the stones of such origin was observed in cases of chronic gunshot osteomyelitis, mainly hips and pelvis, in the treatment of their sulfidina.
In some cases (for example, multiple myeloma, parathyroid osteodystrophies), in addition to the lime salts in the blood come dissolved protein substances, part of the shattered bones. These substances, also standing out with urine, in the tubules of the kidneys precipitate, forming a dense protein cylinders.
The degree of kidney damage is directly proportional to the severity of the process in the bones. Massive destruction of the bones due to the formation of a large number of lime develops metastases picture nephrosis. This process is accompanied by necrosis part of epithelial cells convoluted tubule and regenerative phenomena of the remaining cells, may end up with a shrinkage of the kidney and renal failure. Cm. also Nephrogenic osteopathy.