ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Uremic Bone Disease
Dr. Oktay OYMAKa
aNefroloji Bölümü, Erciyes Üniversitesi Tıp Fakültesi, KAYSERİ
Many patients with chronic kidney diseaes (CKD) often develop secondary hyperparathyroidism (HPT) during the course of the disease. Secondary HPT arises from disturbances in calcium, phosphorus, vitamin D and parathyroid hormone metabolism. Musculoskeletal problems remain among the main limitations of the quality of life of patients treated with long-term maintenance dialysis. Soft-tissue and vascular calcification, cardiovascular disease, and calcific uremic arteriolopathy are other serious complications of the disorder that may contribute directly to cardiovascular morbidity and mortality in patients with CKD. The standard approach to correct mineral metabolism and bone disease in these patients include dietary phosphorus restriction, calcium supplementation, phosphate-binding agents, and treatment with active vitamin-D. However, such medications often have significant effects on the serum levels of calcium and phosphorus, which result in changes that can aggravate soft-tissue and vascular calcification. So, there is a need for new therapeutic interventions that can effectively lower serum or plasma PTH levels without producing untoward side effects. Development of new drugs such as Sevelamer hydrocholride (RenaGel, a calcium- and aluminum-free phosphate binder), Lanthanum carbonate, vitamin D analogs with fewer hypercalcemic effects and calcium-sensing receptor agonists will enable the us to individually tailor the treatment of secondary hyperparathyroidism.Keywords: Chronic kidney disease, secondary hyperparathyroidism, bone disease, dialysis.Turkiye Klinikleri J Int Med Sci 2005, 1(21):45-51
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