A 68-year-old woman comes to the physician for a 1-week history of gradually worsening pain in her right hip. Physical examination shows pain with passive and active range of motion. She has a history of chronic kidney disease managed with dialysis. X-ray of the hip shows a pseudofracture. Which of the following is the most likely explanation for this patient’s presentation?
A) Decreased osteoid
B) Increased bone turnover
C) Osteitis fibrosa cystica
D) Osteomalacia
E) Pathologic reduction of carbonic anhydrase II
