characterized by a lack of bone mineralization but no loss of bone matrix Vitamin D deficiency, or less usually, phosphorus or calcium shortage, may be the cause. Other causes of osteomalacia include enzyme shortages, which lead to insufficient vitamin D production or increased vitamin D breakdown, and decreased phosphorus reabsorption in the renal proximal tubule. Drugs that affect normal vitamin D metabolism, phosphate balance, or bone mineralization can cause osteomalacia. Pettifor