Because rickets results from a metabolic disturbance, the underlying disease should be diagnosed. The causes of rickets can be classified into 11 main categories:
- Vitamin D deficiency
- Dietary deficiency
- Deficient endogenous synthesis
- Gastrointestinal tract disorders
- Small intestine diseases with malabsorption
- Partial or total gastrectomy
- Hepatobiliary disease
- Chronic pancreatic insufficiency
- Disorders of vitamin D metabolism
- Hereditary - Pseudovitamin D deficiency or vitamin D dependency (types I and II)
- Acquired
- Use of anticonvulsants
- Chronic renal failure
- Acidosis
- Distal renal tubular acidosis (classic or type I)
- Secondary forms of renal acidosis
- Ureterosigmoidostomy
- Drug-induced disease
- Chronic acetazolamine ingestion
- Chronic ammonium chloride ingestion
- Chronic renal failure
- Phosphate depletion
- Dietary - Low phosphate intake plus ingestion of nonabsorbable antacids
- Hereditary - X-linked hypophosphatemic rickets or adult-onset vitamin D–resistant hypophosphatemic osteomalacia
- Acquired - Sporadic hypophosphatemic osteomalacia (phosphate diabetes), tumor-associated (oncogenous) rickets, osteomalacia, neurofibromatosis, and fibrous dysplasia
- Dietary - Low phosphate intake plus ingestion of nonabsorbable antacids
- Generalized renal tube disorders
- Primary renal tube disorders
- Renal tube disorders associated with systemic metabolic abnormality
- Cystinosis
- Glycogenosis
- Lowe syndrome
- Systemic disorder with associated renal disease
- Hereditary - Inborn errors (Wilson disease, tyrosinemia) and neurofibromatosis
- Acquired - Multiple myeloma, nephrotic syndrome, and kidney transplantation
- Intoxication-related - Cadmium, lead, outdated tetracycline
- Primary mineralization defects
- Hereditary
- Acquired
- Diphosphonate treatment
- Fluoride treatment
- States of rapid bone formation with or without a relative defect in bone resorption
- Postoperative hyperparathyroidism with osteitis fibrosa cystica
- Osteopetrosis
- Defective matrix synthesis - Fibrogenesis imperfecta ossium
- Miscellaneous
- Magnesium-dependent conditions
- Axial osteomalacia
- Parenteral alimentation
- Aluminum intoxication
- Isofosfamide treatment
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