Since the observations of Lucas, in 1883,1 it has been known that abnormalities of the skeletal system occur in patients ill with chronic renal disease. These include rickets, osteomalacia, osteoporosis, osteosclerosis, and osteitis fibrosa.2-6 Osteitis fibrosa occurs only in association with primary and secondary hyperparathyroidism. It was, therefore, surprising to find on reviewing the literature very few well-documented instances of renal disease with secondary hyperparathyroidism, i. e., with osteitis fibrosa and significant enlargement of the parathyroid glands. In this paper we report the clinical and pathological features of renal disease with secondary hyperparathyroidism in 17 patients. In addition, the 25 cases reported in detail in the literature are reviewed and the important clinical and pathological features are discussed.
At the present time reliable chemical or biological methods for the assay of parathyroid hormone in blood do not exist. In the absence of such a method, we have