Diagnostics, prevention and correction of low bone metabolism in hemodialysis (HD) patients
Abstract
The aim of present work is to study low calcium dialysate influence on parathyroid function, mineral metabolism condition and bone metabolism in hemodialysis (HD) patients with adynamic bone disease. Diagnostics of osteopathy type was performed on the basis of noninvasive investigation methods, such as the definition of intact parathyroid hormone (PTH), phosphorus and calcium blood levels, markers of osteogenesis (bone fraction of alkaline phosphatase, osteocalcin) and resorptions (C-telopeptid of collagen of the 1st type - β-Crosslaps). 437 patients were examined. The decrease of intact PTH (less than 150 pg/ml) was revealed in 159 patients (36%). HD with low calcium dialysate (Ca2+ concentration - 1,25 mmol/l) was used during 12 months in 46 patients who had three or more symptoms and adynamic bone disease (ABD). The normalization of serum calcium was observed in 86% patients, these changes lead to an increase of intact PTH and following markers of bone remodeling. The optimal range of intact PTH was achieved in 61% cases. So, the correction of hypercalcaemia due to the negative balance of calcium during the dialysis session is able to make PTH secretion more active, treating inadequately low bone metabolism.
About the Authors
A. V. Borisov
ЦЭТ «Фесфарм»
Russian Federation
Russian Federation
A. I. Mordik
ЦЭТ «Фесфарм»
Russian Federation
Russian Federation
E. V. Borisova
ЦЭТ «Фесфарм»
Russian Federation
Russian Federation
I. P. Ermakova
НИИТиИО МЗ РФ, г. Москва
Russian Federation
Russian Federation
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Review
For citations:
Borisov A.V., Mordik A.I., Borisova E.V., Ermakova I.P. Diagnostics, prevention and correction of low bone metabolism in hemodialysis (HD) patients. Nephrology and Dialysis. 2005;7(4):453-457. (In Russ.)
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