Renal osteodystrophy may result in considerable morbidity for patients on hemodialysis or for patients with end-stage renal disease.Secondary hyperparathyroidism, adynamic bone disease and osteomalacia, the main bony problems in chronic renal failure, may all be responsible for a reduction in bone mineral density (BMD). This can result in increased fracture risk and bony pains.By virtue of their age, post-menopausal status (in women), sedentary life-style and treatment (including previous corticosteroids), hemodialysis patients may be expected also to be at risk for developing osteoporosis.