Issues

Management of renal hyperparathyroidism

Journal: Osteologie
ISSN: 1019-1291
Topic:

Kalzium-Phosphat-Stoffwechsel und Knochen

Issue: Issues of 2017 (Vol. 26): HeIssue 3 2017 (131-191)
Pages: 135-138

Management of renal hyperparathyroidism

P. M. Jehle (1, 2, 3), D. Jehle (2, 3), M. Jentzsch (2, 3)

(1) Universitätsmedizin, Universität Halle-Wittenberg, Medizinische Fakultät, Halle; (2) Ev. Krankenhaus Paul Gerhardt Stift, Lutherstadt Wittenberg; (3) KfH-Nierenzentrum, Lutherstadt Wittenberg

Keywords

calcimimetics, phosphate binders, parathyroidectomy, Renal hyperparathyroidism, bone metabolism in dialysis patients, vitamin D analogues

Summary

Chronic kidney disease (CKD) leads to mineral and bone disorder (MBD). Routine therapeutic monitoring includes repetitive measurements of calcium, phosphate, PTH, and bone specific alkaline phosphatase. In unclear cases, bone biopsy is recommended. In only 50 % of patients it is possible to achieve target levels for calcium, phosphate and PTH by treatment with calcimimetics, vitamin D analogues and phosphate binders. Bone metabolism should be balanced to avoid extreme situations such as low- and high-turnover osteopathy. Thereby the capacity of bone to incorporate calcium and phosphate could be preserved.

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