ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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The Following Up And Management Of Renal Osteodystrophy ın Dialysis Patients
Dr. Neslihan SEYREKa
aNefroloji BD, Çukurova Üniversitesi Tıp Fakültesi, ADANA
Renal osteodystrophy (ROD) occurs in early stage of chronic kidney disease (CKD) and causes metabolic and morphological changes in bone. Secondary hyperparathyroidism in CKD is releated to the abnormalities of calcium, phosphorus, vitamin D and parathyroid hormone and uremic bone changes are classified in 2 groups as high turnover and low turnower bone disease. Besides the abnormalities of skeleton, soft tissue and vascular calcifications, cardiovascular disease may accompany ROD. As a result of there changes ROD has been known as a serious complication that effects mortality and morbidity, in CKD. Serum levels of calcium, phosphorus, parathormone, alkaline phosphatase, 25-OH vitamin D are important parameters in diagnosis and as well treatment of ROD. Bone biopsy is the gold standard for diagnosis. Dialysis, phosphorus restriction, phosphorus binding drugs, active vitamin D are placed in treatment of ROD. Because of hypercalcemia during conventional therapy (calcium, vitamin D), new treatment options are being used in recent year. There therapeutic agents are sevelamer hydrochloride, lanthanum carbonate as phosphate binders, vitamin D analogs and calcimimetics. Parathyroidectomy is another therapeutic approach for the patients with severe hyperparathyroidism.Keywords: Dialysis, renal osteodystrophy, calcium, phosphorus, parathormone, bone disease, secondary hyperparathyroidism, treatmentTurkiye Klinikleri J Int Med Sci 2006, 2(4):55-62
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