Renal rickets is rickets resulting from chronic renal insufficiency. Renal dwarfism may refer to the same condition and implies dwarfism caused by renal rickets. Renal infantilism refers to such cases as show dwarfism plus hypoplasia of the genitalia. Both the term dwarfism and infantilism in this regard have the disadvantage of distracting from the idea that kidney disease and rickets are the underlying disorders. In some instances renal infantilism is an actual misnomer applying to infantilism with diabetes insipidus without concomitant kidney disease, both the infantilism and the diabetes being pituitary in origin.
In some cases renal rickets may be difficult to distinguish from primary hyperparathyroidism especially when it occurs in growing individuals. In some of the cases in the literature reviewers have disagreed on the origin of the disease, the same cases being classified by one author as primary renal disease and by others as primary hyperparathyroidism. The reason for this is that in both instances when the kidney damage reaches a certain point the effect upon blood chemistry, calcium balance, and the skeleton may become indistinguishable.
In cases in which the differential diagnosis is difficult, the history is one of the most important points. In hyperparathyroidism skeletal changes precede evidence of renal damage, while in renal rickets kidney disease has existed for a long time before bony damage becomes apparent. Hyperparathyroidism may exist without any recognizable x-ray evidence of bony disease, but in those instances in which the parathyroid disease has resulted in severe kidney damage clear-cut changes. . .