Case 7-1974

Presentation of Case A 38-year-old woman was admitted to the hospital because of chronic renal disease. Two years before admission she was found to have chronic renal failure with anemia; x-ray studies showed that both kidneys were small. A low-protein diet was prescribed. One year before entry because of hypercalcemia she was referred to this hospital, where elevated serum levels of parathyroid hormone were found. A biopsy of bone revealed osteitis fibrosa and osteomalacia. A diagnosis was made of chronic renal failure of unknown cause, with secondary hyperparathyroidism, and aluminum carbonate therapy was instituted. During the year before admission the . . .