TREATMENT OF OSTEOMALACIA OF RENAL TUBULAR ACIDOSIS BY SODIUM BICARBONATE ALONE

Abstract

Healing of osteomalacia in response to treatment with sodium bicarbonate alone was compared in two women with renal tubular acidosis. One had normal glomerular function, the other had chronic renal failure as a result of nephrocalcinosis and renal calculi. The bone pain of the woman with normal glomerular function was quickly relieved, and osteomalacia healed completely within one year of correction of acidosis by regular treatment with sodium bicarbonate. Acidosis was not completely corrected in the uræmic woman: bone pain was relieved and pseudofractures healed, but her serum-alkaline-phosphatase remained high during treatment with alkali until she was treated with a large dose of calciferol (vitamin D 2). It is suggested that osteomalacia in patients with renal tubular acidosis who are not uræmic should, in the first instance, be treated with alkali alone because of the dangers inherent in treatment with vitamin D.