Renal Osteodystrophy: A Fresh Approach

Inclusion Criteria: * Aged 18 years or older; * Chronic maintenance dialysis of at least 3 months' duration; * Mental competence; * Willingness to participate in the study; * Calcidiol levels within normal range. Exclusion Criteria: * Pregnancy; * Systemic illnesses or organ diseases that may affect bone (except type 1 or type 2 diabetes mellitus); * Clinical condition that may limit study participation (e.g., unstable angina, respiratory distress, infections). * Chronic alcoholism and/or drug addiction; * Participation in a study of an investigational drug during the past 90 days; * Allergy to tetracycline. * Planning to move out of the area within 2 years of the study; * On active transplant list; * Treatment within last 6 months with drugs that may affect bone metabolism (except for treatment with calcitriol, vitamin D analogs and/or calcimimetics). * Calcidiol level below the normal range. The current routine clinical practice in our dialysis clinics is to check calcidiol status twice yearly and supplement with vitamin D according to serum calcidiol levels. It is therefore unlikely that a substantial number of patients will be excluded due to this exclusion criterion.