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Management of musculoskeletal complications in endstage renal disease: an update

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Abstract

People treated with prolonged hemodialysis now survive longer and increasingly develop musculoskeletal complications. Significant advances have been made in the management of musculoskeletal manifestations in patients undergoing hemodialysis for endstage renal disease. Noncalcium-based phosphate binders are preferred for the management of hyperphosphatemia. Vitamin D therapy is based on intact parathyroid hormone levels. Newer Vitamin D sterols and calcimimetic agents seem to control secondary hyperparathyroidism without increasing the calcium–phosphorous product. Use of biocompatible dialyzers for hemodialysis may delay articular manifestations of beta-2 microglobulin amyloidosis. Beta-2 microglobulin adsorption columns when used along with hemodialysis may lead to lower beta-2 microglobulin levels and improvement in articular manifestations of beta-2 microglobulin amyloidosis. In this review, we focus on the latest advancements in the management of secondary hyperparathyroidism and beta-2 microglobulin amyloidosis.

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Authors and Affiliations

  1. Department of Medicine, Lincoln Medical and Mental Health Center, 234 E. 149th Street, Bronx, NY, 10451, USA

    Dharmarajan Ramaswamy, Isaiarasi Gnanasekharan & Anita Soni

  2. Department of Medicine, University of Medicine and Dentistry New Jersey, 90 Bergen Street, DOC 4700, Newark, NJ, 07103, USA

    Petros Efthimiou

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  1. Dharmarajan Ramaswamy
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  2. Petros Efthimiou
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  3. Isaiarasi Gnanasekharan
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  4. Anita Soni
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Correspondence to Dharmarajan Ramaswamy.

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Ramaswamy, D., Efthimiou, P., Gnanasekharan, I. et al. Management of musculoskeletal complications in endstage renal disease: an update. Clin Rheumatol 25, 440–442 (2006). https://doi.org/10.1007/s10067-005-0072-6

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  • DOI: https://doi.org/10.1007/s10067-005-0072-6

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