Acidosis-induced osteomalacia: Metabolic studies and skeletal histomorphometry

K. R. Phelps, T. A. Einhorn, V. J. Vigorita, R. L. Lieberman, J. Uribarri

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


The pathogenesis of osteomalacia was investigated in three patients with chronic metabolic acidosis. Serum levels of parathyroid hormone and vitamin D metabolites were measured, and bone biopsy specimens were analyzed after double tetracycline labeling. Parathyroid hormone concentrations were normal in patients 1 and 3 and slightly elevated in patient 2. Vitamin D metabolism was undisturbed. Static indicators of bone remodeling substantiated the diagnosis of osteomalacia in each case. In patient 1 fluorescent microscopy revealed no evidence of tetracycline uptake. In patients 2 and 3 active mineralization was evident at all osteoid seams, but because double labels were rare, the mineral apposition rate appears to have been substantially reduced in most bone-forming units. Our results indicate that acidosis-induced osteomalacia, unlike that due to vitamin D deficiency, may be associated with mineral deposition at every possible site. Nevertheless, like other causes of osteomalacia, metabolic acidosis prevents mineral apposition at a normal rate even if mineral deposition is ubiquitous. We suggest that titration of newly deposited phosphate causes the observed impairment of mineral apposition and ultimately leads to osteomalacia.

Original languageEnglish
Pages (from-to)171-179
Number of pages9
Issue number3
StatePublished - 1986
Externally publishedYes


  • Histomorphometry
  • Metabolic Acidosis
  • Osteomalacia
  • Renal Tubular Acidosis
  • Ureteroenterostomy
  • Vitamin D


Dive into the research topics of 'Acidosis-induced osteomalacia: Metabolic studies and skeletal histomorphometry'. Together they form a unique fingerprint.

Cite this