Clues to recognition of kidney disease in archeologic record: characteristics and occurrence of leontiasis ossea

Abstract

The paucity of reports on renal disease in the archeologic literature seems remarkable, given the prominence of renal disease as a cause of death (1). Renal insufficiency allows waste products to accumulate, calcium loss, and reduced kidney hydroxylation of vitamin D, resulting in renal osteodystrophy. The latter describes a combination of osteomalacia (referred to as rickets in subadults) and hyperparathyroid bone disease (2). The combination of hyperparathyroidism and osteomalacia produces a very characteristic osseous picture, at least radiologically (2). While these changes may be well recognized in contemporary patients on dialysis (3-5), it is unclear how often the non-dialyzed person (analogous to individuals from archeologic sites) survives long enough for these findings to be observed (6). The aim of this project was to characterize the osseous lesions in individuals diagnosed in life with chronic renal failure and to examine the corollary question - can kidney disease be recognized from examination of skeletons?