Persistent hypophosphataemia and osteomalacia in dialysis patients not on oral phosphate-binders: Response to dihydrotachysterol therapy.
Four patients who had been on regular haemodialysis for periods of 3 1/2 to 7 years became hypophosphataemic with plasma-phosphate concentrations of 2.5 mg/dl or less before dialysis. None of them had been taking oral phosphate-binders for 2 years or more. Histologically all the patients had an excess of osteoid on bone biopsy. Intestinal absorption of phosphate and calcium was impaired, despite normal or high serum-25-hydroxycholecaliferol concentrations. Treatment with oral dihydrotachysterol resulted in corrections of the phosphate malabsorption and increases in plasma-phosphate concentration. The initial low plasma-phosphate values in these patients before dialysis probably reflected a state of phosphate depletion caused by the combination of malabsorption, loss during dialysis, and a low dietary intake.
D000328:Adult; D001842:Bone and Bones / Q000378:metabolism; D003677:Deficiency Diseases / Q000188:drug therapy / Q000209:etiology; D004097:Dihydrotachysterol / Q000627:therapeutic use*; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D008286:Malabsorption Syndromes / Q000150:complications / Q000188:drug therapy; D008297:Male; D010018:Osteomalacia / Q000188:drug therapy / Q000209:etiology*; D010710:Phosphates / Q000172:deficiency* / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*
D010710:Phosphates; D004097:Dihydrotachysterol