Management of calcium and bone abnormalities in hemodialysis patients.
In chronic renal failure, hyperphosphatemia, hypocalcemia, hyperparathyroidism, reduced activation of vitamin D, decreased level of calcium-sensing receptor, osteitis fibrosa, and osteomalacia are features related to calcium abnormalities. Hyperparathyroidism is a risk factor for survival of hemodialysis patients as well as hypoparathyroidism, which is another feature in hemodialysis patients. Treatment of these abnormalities includes control of parathyroid hormone (PTH) secretion, counteracting hyperphosphatemia, correction of hypocalcemia, and others. Various kinds of vitamin D analogs have been introduced recently in addition to calcitriol and alfacalcidol, which have a rather long history (eg, maxacalcitol and falecalcitriol). Sevelamer is a newly developed phosphate binder to treat soft-tissue calcification.
Morii
Hirotoshi
H
Osaka City University, Osaka, Japan.
Inoue
Tayuki
T
Nishijima
Takaaki
T
Tomokuni
Takashi
T
Ishikawa
Takatoshi
T
Moriya
Kenji
K
Kawai
Nobuaki
N
Araki
Hiroyuki
H
Horio
Misa
M
Shigeoka
Tsutomu
T
Tani
Koji
K
Yamaguchi
Tadashi
T
Kubodera
Noboru
N
D001847:Bone Diseases / Q000188:drug therapy* / Q000209:etiology*; D002128:Calcium Metabolism Disorders / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000627:therapeutic use
D014807:Vitamin D