Dr Kimberly Rieniets D.O.

West Denver Endocrinology LLC


Belmar Plaza, , 215 S Wadsworth Blvd, Suite 530
 Lakewood, CO 80226

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Metabolic Bone Diseases

Metabolic bone disease refers to a variety of disorders that affect bone strength or structure. Osteoporosis is the most widespread of these conditions, but there are a number of other metabolic bone diseases that can lead to fractures, deformity and abnormal functioning if not treated promptly. These disorders may be the result of genetic factors, diet and lifestyle, or other underlying disease conditions.


Osteoporosis is a very common bone disease characterized by increasing bone loss that can lead to fractures, height loss and kyphoscoliosis, a curved, hump-backed appearance. Osteoporotic bones are so weak that it doesn't always require a fall to cause injury. Spinal compression fractures, for example, can be triggered simply by bending over.

Post-menopausal women are at the highest risk of developing the disease. Other factors that predispose patients to osteoporosis include heredity, a slender build, fair complexion, poor nutrition, a sedentary lifestyle, smoking, excessive alcohol consumption and steroid use.Osteoporosis is treated by attempting to prevent further bone loss by altering the diet and supplementing it with calcium and vitamin D.


Osteomalacia, also known as rickets, is a softening of the bones that occurs as a result of a severe vitamin D deficiency. This condition leads to dull aching pain, muscle weakness and an increased risk of fractures, especially within the ribs, spine and legs.

Treatment for osteomalacia focuses on correcting the vitamin D deficiency through oral supplements or injections. Long-term dietary changes are also advised. Certain underlying conditions, such as kidney failure, celiac disease or liver disorders, may cause nutrient absorption problems that lead to osteomalacia as well. Treating these conditions can also help relieve symptoms. More advanced cases of osteomalacia may require leg braces or surgery.

Paget's Disease

Paget's disease is a chronic disorder of bone metabolism, causing bones to become fragile and incapable of normal regeneration. Patients with Paget's disease produce new bone at an accelerated rate, but the new bone is abnormally soft and weak. Patients who suffer with this disorder frequently suffer pain and fatigue, and are at increased risk of fractures, bone deformities, and arthritis. Symptoms of Paget's disease are usually most pronounced in the spine, thigh, pelvis, collar bone or upper arm. Some patients also experience tingling, numbness or stiffness in these body parts.

Treatments for Paget's disease include oral or injectable medications, anti-inflammatory drugs, and specially manufactured footwear or orthotics. In the case of severely damaged bones, surgery may be necessary.

Chronic Kidney Disease-Mineral and Bone Disorder

Chronic kidney disease-mineral and bone disorder (CKD-MBD), also known as renal osteodystrophy, is a consequence of kidney dysfunction. When the kidneys do not work properly, the body fails to maintain appropriate blood levels of calcium and phosphorus, and the bones are affected. CKD-MBD is common in patients with kidney disease, and an almost universal complication for patients on dialysis. Because the condition slows bone growth and can cause deformities, CKD-MBD is most problematic in children, whose bones are still growing. They may be of abnormally short stature and may have a deformity of the legs known as "renal rickets." In adults, CKD-MBD can begin affecting the bones years before patients experience symptoms, so the disease has been called a "silent crippler. Left untreated, CKD-MBD in adults results in gradually thinning bones, bone and joint pain and increased risk of fracture.

Parathyroid Disorders

The parathyroid glands, located in the neck, help to control the level of calcium in the blood. If they malfunction, they can cause blood calcium levels to become abnormal. Either hyperparathyroidism or hypoparathyroidism can lead to bone loss that, if untreated, may lead to bone fractures, curvature of the spine and loss of height. Hypoparathyroidism is usually treated by administration of calcium and vitamin D, while hyperparathyroidism requires medication and, frequently, surgical removal of the affected glands.

Disorders of Mineral Metabolism

The mineral balance in the body is a delicate one, with a deficiency or excess of one substance often affecting the level of another. When the body fails to maintain an appropriate balance of calcium, phosphorus and magnesium on its own, due to a variety of gastrointestinal, kidney, and bone conditions, medical intervention is necessary.

Chemotherapy-Induced Bone Loss

As an unfortunate consequence of the chemotherapy used to treat various cancers, patients may experience bone loss. Several strong medications, known as bisphosphonates, are helpful in preventing or treating this serious side effect.

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