Role of parathyroid hormone and therapy with active vitamin D sterols in renal osteodystrophy.

Abstract:

:Renal osteodystrophy (ROD) represents a spectrum of bone lesions ranging from a high-turnover to a low-turnover state. The expression of the histologic bone lesions is modulated by parathyroid hormone (PTH), vitamin D, calcium, phosphorus, and aluminum that act as major regulators of osteoblastic activity and bone formation rate. The availability of immunometric PTH assays has allowed reasonable prediction of the subtypes of bone lesions in patients with chronic kidney disease (CKD). PTH levels as measured by these assays, however, may not reflect the true bone turnover state during treatment with intermittent active vitamin D. Early diagnosis and appropriate treatment of renal bone disease are essential in preventing the debilitating consequences of ROD on the growing skeleton. Calcitriol and calcium-containing phosphate binders have been the mainstay of treatment for secondary hyperparathyroidism. Complications such as hypercalcemia, vascular calcifications, and the development of adynamic bone may arise from aggressive treatment. New vitamin D analogs and calcium-free phosphate binders are promising in terms of limiting these complications. The management of ROD should be tailored to maintain normal rates of bone formation and turnover with age-appropriate serum calcium and phosphorus levels and with serum PTH levels that correspond to normal rates of skeletal remodeling. These treatment goals would maintain bone health, maximize growth potential, and prevent the development of soft tissue and vascular calcifications.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Hernandez JD,Wesseling K,Salusky IB

doi

10.1111/j.1525-139X.2005.18404.x

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

290-5

issue

4

eissn

0894-0959

issn

1525-139X

pii

SDI18404

journal_volume

18

pub_type

杂志文章,评审
  • Clinical experience with continuous flow and flow-through peritoneal dialysis.

    abstract::Concern over the inherent inefficiency of solute removal by conventional peritoneal dialysis (PD) has led to renewed interest in continuous flow PD (CFPD). We present clinical data from two experiences with CFPD. In the first, two catheters were used to recirculate a fixed intraperitoneal volume through an external ci...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1046/j.1525-139x.2001.00099.x

    authors: Amerling R,DeSimone L,Inciong-Reyes R,Pangilinan A,Folden T,Ronco C,Gotch FA,Levin N

    更新日期:2001-09-01 00:00:00

  • Doppler ultrasound: a powerful tool for vascular access surveillance.

    abstract::National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines recommend Doppler ultrasound (DU) for surveillance of vascular access (VA), but trials have not been unanimous about its benefit on VA patency. The aim of this study was to evaluate the accuracy of DU for patency, as well as t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12334

    authors: Guedes Marques M,Ibeas J,Botelho C,Maia P,Ponce P

    更新日期:2015-03-01 00:00:00

  • Ethical conflicts for physicians treating ESRD patients.

    abstract::Managing an end-stage renal disease (ESRD) patient is complex and presents many ethical challenges for the physician. Ownership of dialysis facilities has shifted over the past decade from largely nonprofit organizations to large companies whose shareholders are primarily interested in the profitability of their inves...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139x.2004.17102.x

    authors: Bennett WM

    更新日期:2004-01-01 00:00:00

  • Withholding and withdrawing renal support in acute kidney injury.

    abstract::Management of critically ill patients with acute kidney injury (AKI) is mainly limited to supportive therapy, with dialysis as one of the main components. Whether or not to offer dialysis and when to withdraw dialysis is a one of the many choices physicians face in daily clinical practice. Withholding or withdrawing r...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2011.00832.x

    authors: Claure-Del Granado R,Mehta RL

    更新日期:2011-03-01 00:00:00

  • Euvolemia-A critical target in the management of acute kidney injury.

    abstract::It has been clearly established that critically ill patients with sepsis require prompt fluid resuscitation. The optimal amount of fluid and when to taper this resuscitation is less clear. There is a growing evidence that fluid overload leads to acute kidney injury, and increased morbidity and mortality. A clinician's...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1111/sdi.12753

    authors: Colbert GB,Szerlip HM

    更新日期:2019-01-01 00:00:00

  • Fatigue in chronic dialysis patients.

    abstract::Fatigue is common in chronic hemodialysis (HD) patients and impacts on daily living, impairs significantly the quality of life, increases the risk of cardiovascular events and negatively influences survival. Although numerous social, demographic, clinical, and laboratory variables have been associated with fatigue, th...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2011.00956.x

    authors: Bossola M,Vulpio C,Tazza L

    更新日期:2011-09-01 00:00:00

  • The effect of chronic renal failure on hepatic drug metabolism and drug disposition.

    abstract::There is abundant evidence that chronic renal failure (CRF) and end-stage renal disease (ESRD) alter drug disposition by affecting protein and tissue binding and reducing systemic clearance of renally cleared drugs. What is not fully appreciated is that CRF can significantly reduce nonrenal clearance and alter the bio...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2003.03011.x

    authors: Dreisbach AW,Lertora JJ

    更新日期:2003-01-01 00:00:00

  • Bullous skin lesions in a patient undergoing chronic hemodialysis.

    abstract::Porphyria cutanea tarda (PCT) is a vesiculobullous skin disorder characterized by a defect in heme biosynthesis. Reduced activity of the hepatic enzyme uroporphyrinogen decarboxylase (URO-D) results in accumulation of photosensitive porphyrins; this ultimately leads to the skin fragility and blistering that is charact...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2009.00672.x

    authors: Ryali ME,Whittier WL

    更新日期:2010-01-01 00:00:00

  • An Unusual yet "Mg"nificent Indication for Hemodialysis.

    abstract::Hypermagnesemia is an uncommon electrolyte abnormality, due to the fact that magnesium toxicity is only seen in the setting of a massive exposure to exogenous magnesium, often in the setting of renal insufficiency. Here, we report a case of severe hypermagnesemia that resulted in complete paralysis that was secondary ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12479

    authors: Bansal AD,Negoianu D,Warburton KM

    更新日期:2016-05-01 00:00:00

  • A case of uremia-associated pleural effusion in a peritoneal dialysis patient.

    abstract::The development of pleural effusions in ESRD patients is a relatively common occurrence. Uremia, currently a rare cause of effusion, can lead to the development of hemorrhagic pleural fluid collections in patients who are underdialyzed. Uremic pleural effusions should be considered when common etiologies of effusions ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1046/j.1525-139x.2001.00056.x

    authors: Krishnan M,Choi M

    更新日期:2001-05-01 00:00:00

  • Longitudinal assessment of hemodynamic endpoints in predicting arteriovenous fistula maturation.

    abstract::Arteriovenous fistula (AVF) nonmaturation is currently a significant clinical problem; however, the mechanisms responsible for this have remained unanswered. Previous work by our group and others has suggested that anatomical configuration and the corresponding hemodynamic endpoints could have an important role in AVF...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2012.01112.x

    authors: Rajabi-Jagahrgh E,Krishnamoorthy MK,Roy-Chaudhury P,Succop P,Wang Y,Choe A,Banerjee RK

    更新日期:2013-03-01 00:00:00

  • Calcific uremic arteriolopathy: advances in pathogenesis and treatment.

    abstract::Calcific uremic arteriolopathy (CUA) is a rare but serious life-threatening complication of CRF that manifests as painful nonhealing eschars in association with panniculitis and dermal necrosis. This condition is being increasingly recognized and reported as a contributing factor to death in dialysis patients. The pat...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00263.x

    authors: Rogers NM,Teubner DJ,Coates PT

    更新日期:2007-03-01 00:00:00

  • In-center hemodialysis education: Challenges and innovations in training of fellows in nephrology.

    abstract::The in-center dialysis unit and practice of dialysis, in the current multi-team approach, requires knowledge and skills in all the domains including medical expert, communicator, collaborator, scholar, health advocate, and leader. We are tasked as a community, to embrace and incentivize new innovations and technology ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12668

    authors: Moist LM,Lindsay RM

    更新日期:2018-03-01 00:00:00

  • Conservative treatment of the uremic syndrome.

    abstract::In addition to extracorporeal renal replacement strategies, which in chronic kidney disease (CKD) are largely reserved for the treatment of end-stage kidney failure, conservative measures can be taken to reduce concentration, effects, or both concentration and effects of uremic retention solutes. In this overview, we ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2009.00600.x

    authors: Vanholder R,Argilés A,Beige J,Brunet P,Drüeke TB,Fliser D,Herget-Rosenthal S,Hörl WH,Jörres A,Perna A,Rodriguez-Portillo M,Spasovski G,Stegmayr B,Stenvinkel P,Wanner C,Wiecek A,Massy ZA

    更新日期:2009-07-01 00:00:00

  • Thigh grafts: a preferable alternative to catheters when upper extremity access sites are exhausted.

    abstract::Hemodialysis patients with failed upper extremity (arm) access sites comprise 5-10% of the dialysis population. In these patients, arm vessels are either unsuitable for access placement due to trauma or peripheral vascular disease, or have been exhausted following dialysis usage. Synthetic grafts in the lower extremit...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2009.00613.x

    authors: Abreo KD,Ram SJ

    更新日期:2009-09-01 00:00:00

  • Management of the Dialysis Patient with Sickle Cell Disease.

    abstract::While patients with sickle cell disease currently constitute a very small minority of the US dialysis population (0.1%), there is anticipated growth of this group as the life expectancy of those with sickle cell disease (SCD) increases. SCD patients suffer a high burden of morbidity, which is enhanced by the presence ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12403

    authors: Boyle SM,Jacobs B,Sayani FA,Hoffman B

    更新日期:2016-01-01 00:00:00

  • The body mass index paradox and an obesity, inflammation, and atherosclerosis syndrome in chronic kidney disease.

    abstract::The association of high body mass index (BMI) with better survival in chronic kidney disease (CKD) is considered a "risk factor paradox" or "reverse epidemiology." Since malnutrition is a powerful predictor of death and cardiovascular disease is its leading cause, it has been suggested that malnutrition and atheroscle...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.0894-0959.2004.17311.x

    authors: Beddhu S

    更新日期:2004-05-01 00:00:00

  • Improving hemodialysis patient outcomes: a step-by-step approach.

    abstract::Hemodialysis patient outcomes are often suboptimal, with one-sixth of patients receiving an inadequate dialysis dose, one-fourth using catheters for vascular access, and more than one-half being malnourished. This review describes a four-step approach for improving dialysis patient outcomes. First, select an outcome t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2002.00013.x

    authors: Sehgal AR

    更新日期:2002-01-01 00:00:00

  • Health-related quality of life in nephrology research and clinical practice.

    abstract::Physical, psychosocial, and lifestyle disturbances, along with physical and emotional symptoms, have been shown to impact the health-related quality of life (HRQOL) of those dependent on renal replacement therapy. The value of HRQOL measurement as a tool to improve clinical care has been recognized by patients, clinic...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2005.18206.x

    authors: Unruh ML,Weisbord SD,Kimmel PL

    更新日期:2005-03-01 00:00:00

  • Comparative review of the pharmacokinetics of vitamin D analogues.

    abstract::This article reviews the pharmacokinetic characteristics of calcitriol, paricalcitol, and doxercalciferol, and provides an overview of the metabolism of vitamin D. Calcitriol and paricalcitol have similar pharmacokinetic profiles, with terminal half-lives ranging from 5 to 10 hours in healthy subjects to 15-30 hours i...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2002.00086.x

    authors: Bailie GR,Johnson CA

    更新日期:2002-09-01 00:00:00

  • A position statement from the American Society of Diagnostic and Interventional Nephrology.

    abstract::A procedure-related complication is an unanticipated adverse event that requires therapy. In order to analyze frequency and severity of complications in the process of quality assurance, it is useful to have a classification of complications, indicating the type and severity. The Clinical Practice Committee of America...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2007.00318.x

    authors: Vesely TM,Beathard G,Ash S,Hoggard J,Schon D,ASDIN Clinical Practice Committee.

    更新日期:2007-07-01 00:00:00

  • In-center thrombolysis for clotted AV access: a cohort review.

    abstract::Thrombosis is the leading cause of arteriovenous (AV) access failure for hemodialysis patients requiring frequent interventions. We describe a novel approach to the lyse-and-wait technique in thrombosed AV access using nurse-administered thrombolytics in a hospital-based hemodialysis unit. All patients at a single-cen...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2012.01105.x

    authors: Umanath K,Morrison RS,Christopher Wilbeck J,Schulman G,Bream P,Dwyer JP

    更新日期:2013-01-01 00:00:00

  • Changing dialysate composition to optimize acid-base therapy.

    abstract::In response to rapid alkali delivery during hemodialysis, hydrogen ions (H+ ) are mobilized from body buffers and from stimulation of organic acid production in amounts sufficient to convert most of the delivered bicarbonate to CO2 and water. Release of H+ from nonbicarbonate buffers serves to back-titrate them to a m...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12779

    authors: Sargent JA,Marano M,Marano S,Gennari FJ

    更新日期:2019-05-01 00:00:00

  • Management of hyperkalemia in dialysis patients.

    abstract::Hyperkalemia is common in patients with end-stage renal disease, and may result in serious electrocardiographic abnormalities. Dialysis is the definitive treatment of hyperkalemia in these patients. Intravenous calcium is used to stabilize the myocardium. Intravenous insulin and nebulized albuterol lower serum potassi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2007.00312.x

    authors: Putcha N,Allon M

    更新日期:2007-09-01 00:00:00

  • The ADEMEX study and its implications for peritoneal dialysis adequacy.

    abstract::In an attempt to improve patient outcomes in peritoneal dialysis (PD), national organizations (such as the National Kidney Foundation Dialysis Outcomes Quality Initiative [NKF-DOQI] process) have formulated clinical practice guidelines based on clinical evidence available at the time of development. For "adequacy" of ...

    journal_title:Seminars in dialysis

    pub_type: 评论,社论

    doi:10.1046/j.1525-139x.2003.03001.x

    authors: Burkart JM

    更新日期:2003-01-01 00:00:00

  • Dialysis cannot be dosed.

    abstract::Adequate dialysis is difficult to define because we have not identified the toxic solutes that contribute most to uremic illness. Dialysis prescriptions therefore cannot be adjusted to control the levels of these solutes. The current solution to this problem is to define an adequate dose of dialysis on the basis of fr...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2011.00979.x

    authors: Meyer TW,Sirich TL,Hostetter TH

    更新日期:2011-09-01 00:00:00

  • Surface-area-normalized Kt/V: a method of rescaling dialysis dose to body surface area-implications for different-size patients by gender.

    abstract::Dialysis is measured as Kt/V, which scales the dose (Kt) to body water content (V). Scaling dialysis dose to body surface area (S(dub)) has been advocated, but the implications of such rescaling have not been examined. We developed a method of rescaling measured Kt/V to S(dub) and studied the effect of such alternativ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2008.00482.x

    authors: Daugirdas JT,Depner TA,Greene T,Kuhlmann MK,Levin NW,Chertow GM,Rocco MV

    更新日期:2008-09-01 00:00:00

  • Sonography of Arteriovenous Fistulas and Grafts.

    abstract::Arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) are the vascular accesses of choice for long-term hemodialysis. Strategies to establish and maintain functioning AVFs and AVGs are essential. In addition to clinical evaluation, ultrasound plays a critical role in the evaluation and maintenance of AVFs and ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12599

    authors: Pietryga JA,Little MD,Robbin ML

    更新日期:2017-07-01 00:00:00

  • Consolidation in dialysis Markets-Causes, consequences, and the role of policy.

    abstract::The dialysis industry is one of the most highly concentrated healthcare sectors in the United States. Despite decades of growth in the number of patients with end-stage renal disease and in the size of dialysis markets, two large dialysis organizations currently care for more than two-thirds of the dialysis population...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12855

    authors: Saeed MK,Ho V,Erickson KF

    更新日期:2020-01-01 00:00:00

  • Controversies in timing of dialysis initiation and the role of race and demographics.

    abstract::Dialysis remains the predominant form of renal replacement therapy in the United States, but the optimal timing for the initiation of dialysis remains poorly defined. Not only clinical factors such as signs/symptoms of uremia, co-existing cardiovascular disease, and presence of diabetes but also key demographic charac...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12130

    authors: Streja E,Nicholas SB,Norris KC

    更新日期:2013-11-01 00:00:00