Tags

Type your tag names separated by a space and hit enter

Role of parathyroid hormone and therapy with active vitamin D sterols in renal osteodystrophy.
Semin Dial. 2005 Jul-Aug; 18(4):290-5.SD

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.

Authors+Show Affiliations

Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, California 90095, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

16076350

Citation

Hernandez, Joel D., et al. "Role of Parathyroid Hormone and Therapy With Active Vitamin D Sterols in Renal Osteodystrophy." Seminars in Dialysis, vol. 18, no. 4, 2005, pp. 290-5.
Hernandez JD, Wesseling K, Salusky IB. Role of parathyroid hormone and therapy with active vitamin D sterols in renal osteodystrophy. Semin Dial. 2005;18(4):290-5.
Hernandez, J. D., Wesseling, K., & Salusky, I. B. (2005). Role of parathyroid hormone and therapy with active vitamin D sterols in renal osteodystrophy. Seminars in Dialysis, 18(4), 290-5.
Hernandez JD, Wesseling K, Salusky IB. Role of Parathyroid Hormone and Therapy With Active Vitamin D Sterols in Renal Osteodystrophy. Semin Dial. 2005 Jul-Aug;18(4):290-5. PubMed PMID: 16076350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of parathyroid hormone and therapy with active vitamin D sterols in renal osteodystrophy. AU - Hernandez,Joel D, AU - Wesseling,Katherine, AU - Salusky,Isidro B, PY - 2005/8/4/pubmed PY - 2005/11/11/medline PY - 2005/8/4/entrez SP - 290 EP - 5 JF - Seminars in dialysis JO - Semin Dial VL - 18 IS - 4 N2 - 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. SN - 0894-0959 UR - https://www.unboundmedicine.com/medline/citation/16076350/Role_of_parathyroid_hormone_and_therapy_with_active_vitamin_D_sterols_in_renal_osteodystrophy_ L2 - https://doi.org/10.1111/j.1525-139X.2005.18404.x DB - PRIME DP - Unbound Medicine ER -