Calcium and phosphorus in diet therapy of uremia.
Significant advances have been made in understanding the pathogenesis of renal osteodystrophy. Several factors play a role in the development of uremic bone disease, such as secondary hyperparathyroidism, PTH resistance at the level of bone, abnormalities in vitamin D metabolism, and factors contributing to extraosseous calcification. Through a better understanding of the pathogenetic mechanisms, a more rational approach to the dietary management of patients with chronic renal failure has been possible. In view of present knowledge, the following preventive and therapeutic interventions can be recommended: provision of liberal calcium intake in the diet, appropriate restriction of phosphorus intake, provision of potent vitamin D analogs, and close attention to the calcium-phosphorus product. With careful attention to these recommendations, the bone lesions of secondary hyperparathyroidism and osteomalacia may be minimized and even prevented.
D001842:Bone and Bones / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D002136:Calcium, Dietary / Q000627:therapeutic use*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000209:etiology / Q000517:prevention & control*; D005919:Glomerular Filtration Rate; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D006996:Hypocalcemia / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D010280:Parathyroid Glands / Q000503:physiopathology; D010281:Parathyroid Hormone / Q000378:metabolism; D010758:Phosphorus / Q000008:administration & dosage* / Q000378:metabolism; D006435:Renal Dialysis; D014511:Uremia / Q000178:diet therapy; D014807:Vitamin D / Q000378:metabolism / Q000627:therapeutic use
D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium