Acidosis and bone disease in chronic renal failure

The book is a Doctoral Thesis, 1975, defended by Dr M Cochran at Birmingham University.
In the world of medicine and physiology, controversy existed as to whether rickets associated with kidney disease was in any way linked to the failure of the kidneys to excrete acid (ultimately from dietary sulphate and phosphate). Rickets occurred with long-lasting kidney disease because the disease took time to develop. It was possible that the association with acidification of body fluids was not causative.
The data examined here suggested that there was a causative association between acidosis and the particular type of bone disease (rickets in growing bone, osteomalacia in adult bone) seen with slowly progressing renal disease.
It was possible only to suggest the mechanism. Those favoured were interference with the activity of a bony enzyme; or reduction in the effective available non-acidified phosphate concentration.