Using acid phosphatase as a marker, osteoclasts were examined from single sections of undemineralised iliac crest biopsies from patients with renal failure and from normal controls. Eighty one per cent of the cells from controls and 56% of the cells from patients with renal failure appeared to be non-nucleated or mononucleated. Serial sections showed, however, that 73% of the control cells were actually multinucleated as were 91% of the patients' cells. Howship's lacunae were present in similar proportions in the controls whether the cells were multinucleated or not, suggesting that they should all be classed as osteoclasts. More multinucleated cells and lacunae were present in the patients with renal failure. It is concluded that all acid phosphatase cells adjacent to bone are osteoclasts and that the presence of more lacunae and multinucleated cells in renal failure is compatible with enhanced cellular resorption.
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