Imagistic aspects of lesions of the musculo-skeletal system in patients with secondary hyperparathyroidism undergoing chronic dyalisis Renal osteodystrophy (ROD) is a collective term describing the mixture of pathophysio-logical conditions that afflict the skeletal system of patients with chronic kidney disease (CKD). It is most evident in patients on renal replacement therapy (RRT), but usually starts early in the course of CKD. The spectrum of skeletal abnormalities seen in ROD is classified according to the state of bone turnover. Secondary hyperparathyroidism represents a common disorder in patients with chronic kidney disease (CKD); it develops as a result of hyperphosphatemia, hypocalcemia and impaired synthesis of renal vitamin D with reduction in serum calcitriol levels. Patients with secondary hyperparathyroidism have a range of symptoms that affect their quality of life. In the past two decades, the prevalence of high turnover ROD has decreased while low bone turnover has become increasingly recognized.