Micrograph showing adynamic or aplastic bone disease in end-stage kidney disease

Bone biopsy showing adynamic or aplastic bone disease in end-stage kidney disease. This disorder is characterized by reductions in bone formation and bone resorption that are manifested histologically by thin osteoid seams (red lines at the bone surface; arrows) and little or no evidence of cellular activity.

Histologic appearance of normal bone.
(Left panel) Goldner Masson trichrome stain shows mineralized lamellar bone in blue and adjacent nonmineralized osteoid in red-brown. Osteoid usually comprises less than 25% of bone surfaces. The cellular area between the osseous structures is the marrow space.
(Right panel) Villanueva-stained section viewed under polarized light following time-spaced tetracycline labeling. Osteoid appears orange, mineralized bone is green, and tetracycline markers appear as luminescent yellow-green bands within bone and beneath osteoid (arrow). The distinct dual bands represent active mineralized bone formation.