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FIGURE 7-35 (see Color Plate)

Complications of the use of aluminum-based phosphate binders to control hyperphosphatemia. Appearance of bone section from a patient with end-stage renal disease who was treated with oral aluminum gels to control severe hyperphosphatemia. A bone biopsy was obtained 6 months after a parathyroidectomy was performed. Note the wide areas of osteoid filling previously resorbed bone.

FIGURE 7-36 (see Color Plate)

The same bone section as in Figure 7-35 but under polarizing lenses, illustrating the partially woven appearance of osteoid typical of chronic renal failure.

FIGURE 7-37 (see Color Plate)

The same bone section as in Figure 7-35 with positive aluminum stain of the trabecular surface. These findings are consistent with aluminum-related osteomalacia.

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