Bone Disorders in Chronic Kidney Disease: An Update in Diagnosis and Management.


:Renal osteodystrophy (ROD) is a bone disorder that occurs in chronic kidney disease (CKD) patients and is associated with 2- to 14-fold increased fracture risk compared to the general population. Risk of fractures is also increased in kidney transplant recipients especially within the first 5 years after transplantation. Fractures in CKD patients are associated with increased morbidity and mortality; thus, proper screening and management of CKD bone complications is critical to improving clinical outcomes. Tetracycline double-labeled transiliac crest bone biopsy with histomorphometry is the gold standard for the diagnosis and classification of ROD. However, bone biopsy is not practical to obtain in all patients. Thus, there is great interest in noninvasive approaches that can be used in the clinic to assess ROD. Here, we discuss the role of surrogate measures of bone health in CKD patients, such as dual energy X-ray absorptiometry (DXA) and novel high-resolution imaging, in conjunction with biochemical biomarkers of bone turnover. Recommended guidelines for diagnosis and management of CKD-MBD are discussed.


Semin Dial


Seminars in dialysis


Babayev R,Nickolas TL




Has Abstract


2015-11-01 00:00:00












  • Ultrapure dialysate.

    abstract::To prevent pyrogenic reactions during hemodialysis, it is recommended that bacteria and endotoxin in dialysate not exceed 100-200 colony forming units (CFU)/ml and 0.25-2 endotoxin units (EU)/ml, respectively. While these limits are adequate to prevent acute pyrogenic reactions, data are accumulating to suggest they m...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Ward RA

    更新日期:2004-11-01 00:00:00

  • Starting a home hemodialysis program.

    abstract::Home hemodialysis is not a new therapy; rather it is a therapy in which interest has been rekindled due to both the continually growing end-stage renal disease population and concern about poor outcomes in patients on conventional thrice-weekly in-center dialysis. The practical issues to be considered when starting a ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Moran J,Kraus M

    更新日期:2007-01-01 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


    authors: Burkart JM

    更新日期:2003-01-01 00:00:00

  • Therapeutic plasma exchange for renal-related conditions in the elderly: ten years experience in one center.

    abstract::The elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal i...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Hayes JS,Balogun RA,Chang J,Abdel-Rahman EM

    更新日期:2012-03-01 00:00:00

  • Policies to promote timely referral for kidney transplantation.

    abstract::There are numerous patient, provider, and health system barriers to accessing kidney transplantation. Patient barriers such as sociocultural and clinical characteristics and provider factors such as provider knowledge and awareness of transplantation play important roles in facilitating transplant. Health system facto...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Patzer RE,Pastan SO

    更新日期:2020-01-01 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


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

    更新日期:2016-01-01 00:00:00

  • Geriatric assessment for the nephrologist.

    abstract::Dialysis providers are increasingly being presented with progressively older and frailer patients, in all healthcare settings from the acute hospital to the community dialysis center. These patients commonly bring more than kidney failure with them, with a complex constellation of chronic illness, comorbidity, and fun...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Wiggins J,Bitzer M

    更新日期:2012-11-01 00:00:00

  • Inflammatory biomarkers and cardiovascular risk: association or cause and effect?

    abstract::With the current understanding that atherosclerosis is an inflammatory disorder, markers of the associated systemic inflammatory response have been extensively studied as predictors of cardiovascular disease. Recently the use of high-sensitivity C-reactive protein (hsCRP) has been proposed for risk assessment in indiv...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Rao M,Jaber BL,Balakrishnan VS

    更新日期:2006-03-01 00:00:00

  • Cardiovascular disease in chronic renal failure: pathophysiologic aspects.

    abstract::Cardiovascular complications are the leading cause of mortality in patients with end-stage renal disease (ESRD). The excess cardiovascular risk and mortality is already demonstrable in early renal disease and in patients with chronic renal failure (CRF), with the highest relative risk of mortality in the youngest pati...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: London GM

    更新日期:2003-03-01 00:00:00

  • The failed renal transplant: in or out?

    abstract::With the increased number of renal transplants being performed in the United States, there are also increasing numbers of early and long-term allograft failures. Patients with failed allografts require reentry into the end-stage renal disease (ESRD) system. If an allograft is producing little in the way of morbidity, ...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审


    authors: Bennett WM

    更新日期:2005-05-01 00:00:00

  • Surgical Management of Complications with Peritoneal Dialysis.

    abstract::This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. Th...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Ratajczak A,Lange-Ratajczak M,Bobkiewicz A,Studniarek A

    更新日期:2017-01-01 00:00:00

  • A survey of current procedural practices of Australian and New Zealand nephrologists.

    abstract::The aim of this study was to describe the range and extent of current procedural practices of Nephrologists and trainees in Australia and New Zealand with a specific focus on renal biopsy. A web-based survey was constructed based on a 2009 pilot survey conducted by the authors. The survey was distributed by email. A t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Ritchie AG,Saunders J,Baer R,May S,Australian and New Zealand Special Interest Group in Interventional Nephrology Research Collaboration.

    更新日期:2013-11-01 00:00:00

  • Alternate night nocturnal hemodialysis: the Australian experience.

    abstract::Alternate night nocturnal hemodialysis (HD) is a popular modality in Australia. This modality grew out of a desire to increase the availability and accessibility of nocturnal HD without incurring excessive costs. It has proven popular with staff, patients, and administrators. There are limited data to support the bene...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Kerr PG,Agar JW,Hawley CM

    更新日期:2011-11-01 00:00:00

  • Minerals in dialysis therapy: an introduction.

    abstract::The 180 l of glomerular filtrate formed each day contain some 1100 g (2.5 pounds) of sodium chloride, of which only 5-10 g are excreted in the urine--95% is reabsorbed by the tubules. Some 425 g (nearly a pound) of sodium bicarbonate and 145 g of glucose are filtered, and more than 99% of both are reabsorbed. Also fil...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Weisberg LS,Zanger R

    更新日期:2010-11-01 00:00:00

  • Decreasing hospitalizations in patients on hemodialysis: Time for a paradigm shift.

    abstract::Hospitalizations drive up to 35% of the astronomical costs of care for patients on hemodialysis and are associated with poor outcomes. We describe outpatient care-sensitive categories of hospitalization risks in an effort to engage stakeholders and patients, as stakeholders, in mitigating hospitalizations. These categ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Golestaneh L

    更新日期:2018-05-01 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


    authors: Bossola M,Vulpio C,Tazza L

    更新日期:2011-09-01 00:00:00

  • Strategy for maximizing the use of arteriovenous fistulae.

    abstract::Increasing the use of arteriovenous fistulae in dialysis patients requires a specific strategy. In order to properly select patients for an arteriovenous fistula (AVF), it is essential that the nephrologist become knowledgeable about the subject and that an organized approach be followed. Both the arterial and venous ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Beathard GA

    更新日期:2000-09-01 00:00:00

  • Laughter and humor therapy in dialysis.

    abstract::Laughter and humor therapy have been used in health care to achieve physiological and psychological health-related benefits. The application of these therapies to the dialysis context remains unclear. This paper reviews the evidence related to laughter and humor therapy as a medical therapy relevant to the dialysis pa...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Bennett PN,Parsons T,Ben-Moshe R,Weinberg M,Neal M,Gilbert K,Rawson H,Ockerby C,Finlay P,Hutchinson A

    更新日期:2014-09-01 00:00:00

  • Retrospective analysis of catheter recirculation in prevalent dialysis patients.

    abstract::Catheter recirculation (CR) occurs when blood returning from the venous limb of the catheter re-enters the arterial limb of the catheter without passage through the circulation. Adequacy of dialysis is influenced by the degree of access recirculation. In this study we evaluate factors influencing the degree of dialysi...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Moossavi S,Vachharajani TJ,Jordan J,Russell GB,Kaufman T,Moossavi S

    更新日期:2008-05-01 00:00:00

  • Is surgical salvage of arteriovenous grafts feasible after unsuccessful percutaneous mechanical thrombectomy?

    abstract::Treatment of thrombosed dialysis ateriovenous (AV) grafts in the radiology interventional suite requires percutaneous mechanical thrombectomy, along with angioplasty of the underlying stenotic lesion. We analyzed the anatomic reasons for unsuccessful percutaneous thrombectomy of AV grafts, and assessed the feasibility...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章


    authors: Maya ID,Smith T,Young CJ,Allon M

    更新日期:2008-03-01 00:00:00

  • Long-term outcomes and management considerations after parathyroidectomy in the dialysis patient.

    abstract::Parathyroidectomy (PTX) remains an important intervention for dialysis patients with poorly controlled secondary hyperparathyroidism (SHPT), though there are only retrospective and observational data that show a mortality benefit to this procedure. Potential consequences that we seek to avoid after PTX include persist...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Kakani E,Sloan D,Sawaya BP,El-Husseini A,Malluche HH,Rao M

    更新日期:2019-11-01 00:00:00

  • Evidence-based review of gastrointestinal bleeding in the chronic kidney disease patient.

    abstract::Patients with end-stage renal disease are more likely to suffer from gastrointestinal (GI) problems, including bleeding from upper and lower sources. Peptic ulcer disease is the most common cause of upper GI bleeding, and although there is some debate in the literature regarding whether the frequency of ulcer disease ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Kalman RS,Pedrosa MC

    更新日期:2015-01-01 00:00:00

  • How do calcimimetics fit into the management of parathyroid hormone, calcium, and phosphate disturbances in dialysis patients?

    abstract::As suggested by its American brand name (Sensipar), the calcimimetic cinacalcet sensitizes the parathyroid cells to the extracellular calcium signal, suppressing parathyroid hormone (PTH) release and synthesis and preventing parathyroid cell proliferation. This primary PTH suppression decreases the release of calcium ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Shahapuni I,Mansour J,Harbouche L,Maouad B,Benyahia M,Rahmouni K,Oprisiu R,Bonne JF,Monge M,El Esper N,Presne C,Moriniere P,Choukroun G,Fournier A

    更新日期:2005-05-01 00:00:00

  • Are dialysate sodium levels too high?

    abstract::Universal lower dialysate [Na+] is often advocated as a means of improving the dire cardiovascular plight of our dialysis patients. However, there is evidence associating lower dialysate [Na+] and increased morbidity and mortality especially in frailer patients, probably as a result of more frequent intra-dialytic hyp...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Marshall MR,Dunlop JL

    更新日期:2012-05-01 00:00:00

  • The Overuse, Underuse, and Misuse of Dialysis in ESKD Patients with Dementia.

    abstract::The profile of patients on chronic dialysis has shifted. There is a growing group of older patients with comorbid dementia and ESKD, who are at risk of overuse, underuse, and misuse of dialysis. Policy is lacking to help guide treatment decisions in this group. This paper explores clinical considerations specific to p...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: MacPhail A,Ibrahim JE,Fetherstonhaugh D,Levidiotis V

    更新日期:2015-09-01 00:00:00

  • Temperature control by the blood temperature monitor.

    abstract::The rationale of temperature control during hemodialysis (HD) is to prevent heat accumulation, which increases body temperature and enhances hypotensive susceptibility. Treatments where thermal energy is neither delivered nor removed from the patient through the extracorporeal circulation (so-called extracorporeal the...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Schneditz D,Ronco C,Levin N

    更新日期:2003-11-01 00:00:00

  • Drug therapy for hypertension in hemodialysis patients.

    abstract::The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Hörl MP,Hörl WH

    更新日期:2004-07-01 00:00:00

  • The other side of the coin: impact of toxin generation and nutrition on the uremic syndrome.

    abstract::Both the morbidity of the uremic syndrome and the generation of uremic toxins are attributed to malnutrition. If protein intake and catabolism result in the generation of solutes, then nutritional intake should be related directly to toxicity. On the other hand, inadequate nutrition has been linked to inflammation and...

    journal_title:Seminars in dialysis

    pub_type: 社论


    authors: Vanholder R,Glorieux G,Lameire N

    更新日期:2002-09-01 00:00:00

  • Hyperkalemia in hemodialysis patients.

    abstract::Hyperkalemia contributes significantly to high mortality among ESRD patients. Excess intake and inadequate removal are the most common etiologies in HD patients. Although dialysis is the definitive treatment, classical medical therapy must be employed as a temporizing measure to acutely lower serum potassium. Reducing...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Pani A,Floris M,Rosner MH,Ronco C

    更新日期:2014-11-01 00:00:00

  • Transplantation in diabetic kidney failure patients: modalities, outcomes, and clinical management.

    abstract::Diabetes mellitus (DM) is a common and devastating disease, affecting up to 19.3 million Americans. It is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States. Diabetic patients with ESRD have a high incidence of cardiovascular disease and death. For those kidney tr...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审


    authors: Luan FL,Samaniego M

    更新日期:2010-03-01 00:00:00