Article

Clinical Reviews in Bone and Mineral Metabolism

, Volume 5, Issue 1, pp 27-38

Treatment of renal osteodystrophy

  • Anca Gal-MoscoviciAffiliated withHadassah Hospital Medical Center, Hebrew UniversityDivision of Nephrology and Hypertension, Evanston Northwestern Healthcare, Northwestern University Feinberg School of Medicine
  • , Stuart M. SpragueAffiliated withDivision of Nephrology and Hypertension, Evanston Northwestern Healthcare, Northwestern University Feinberg School of Medicine Email author 
  • , Edgar V. LermaAffiliated withSection of Nephrology, University of Illinois at Chicago College of Medicine/Associates in Nephrology

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Abstract

Chronic kidney disease (CKD) is accompanied by disturbances in calcium, phosphate, vitamin D, and parathyroid hormone (PTH) homeostasis known to play an important role in the pathophysiology of renal osteodystrophy. Increased cardiovascular morbidity and mortality rate among CKD patients, correlates with these disturbances in bone and mineral metabolism and underscores the nephrologist’s concern about the effectiveness of the present therapeutic approach. Treatment directed to normalize the calcium/phosphate, vitamin D and PTH abnormalities may adversely affect endothelial, vascular and bone cells activity. This article discusses the therapeutic approaches focuses for renal osteodystrophy.

Key Words

renal osteodystrophy phosphate binders vitamin D receptor agonist cinacalcet parathyroidectomy