Treatment of renal bone disease

  • I. B. Salusky


Renal osteodystrophy is a disorder of bone and mineral metabolism that has long been recognized as a consequence of renal dysfunction. Disturbances in calcium and phosphorus homeostasis, reduced synthesis of 1,25-dihydroxyvitamin D3, altered metabolism of parathyroid hormone (PTH), impaired renal clearance of PTH fragments and accumulation of substances, such as aluminum and β2-macroglobulin, play a critical role in the pathogenesis of the renal bone diseases.


Vascular Calcification Secondary Hyperparathyroidism Phosphate Binder Nephrol Dial Transplant Renal Osteodystrophy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Goodman WG, Coburn JW, Slatopolsky E, Salusky IB. Renal osteodystrophy in adults and children. In: Favus MJ, editor. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. Philadelphia: Lippincott, Williams and Wilkins, 1999: pp. 347–63.Google Scholar
  2. 2.
    Mathias RS, Salusky IB, Harmon WH, Paredes A, Emans J, Segre GV, Goodman WG. Renal bone disease in pediatric patients and young adults treated by hemodialysis in a childrens hospital. J Am Soc Nephrol. 1993;12:1938–46.Google Scholar
  3. 3.
    Salusky IB, Ramirez JA, Oppenheim WL, Gales B, Segre GV, Goodman WG. Biochemical markers of renal osteodystrophy in pediatric patients undergoing CAPD/CCPD. Kidney Int. 1994;45:253–58.PubMedCrossRefGoogle Scholar
  4. 4.
    Sherrard DJ, Hercz G, Pei Y, Maloney N, Greenwood C, Manuel A, Saiphoo C, Fenton SS, Segre GV. The spectrum of bone disease in end-stage renal failure-an evolving disorder. Kidney Int. 1993;43:436–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Cohen-Solal ME, Sebert JL, Boudailliez B, Marie A, Moriniere Ph, Guéris J, Bouillon R, Fournier A. Comparison of intact, midregion, and carboxy-terminal assays of parathyroid hormone for the diagnosis of bone disease in hemodialyzed patients. J Clin Endocrinol Metab. 1991;73:516–24.CrossRefGoogle Scholar
  6. 6.
    Salusky IB, Goodman WG. Growth hormone and calcitriol as modifiers of bone formation in renal osteodystrophy. Kidney Int. 1995;48:657–65.PubMedCrossRefGoogle Scholar
  7. 7.
    Block GA, Hulbert-Shearon TE, Levin NW, Port FK. Association of serum phosphorus and calcium X phosphorus product with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis. 1998;31:607–17.PubMedCrossRefGoogle Scholar
  8. 8.
    Mucsi I, Hercz G, Uldall R, Ouwendyk M, Francoeur R, Pierratos A. Control of serum phosphorus without any phosphate binders in patients treated with nocturnal hemodialysis. Kidney Int. 1998;53:1399–1404.PubMedCrossRefGoogle Scholar
  9. 9.
    Roodhooft AM, Van Hoeck KJ, van Acker KJ. Hypophosphatemia in infants on continuous ambulatory peritoneal dialysis. Clin Nephrol. 1990;34:131–5.PubMedGoogle Scholar
  10. 10.
    Tejeda A, Saffarian N, Uday K, Dave M. Hypophosphatemia in end stage renal disease. Nephron. 1996;73:674–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Goodman WG. Aluminum and renal osteodystrophy. In: Bushinsky DA, editor. Renal Osteodystrophy. Philadelphia: Lippencott-Raven, 1998: pp. 317–45.Google Scholar
  12. 12.
    Coburn JW, Mischel MG, Goodman WG, Salusky IB. Calcium citrate markedly enhances aluminum absorption from aluminum hydroxide. Am J Kidney Dis. 1991;17:708–11.PubMedGoogle Scholar
  13. 13.
    Bakir AA, Hryhorczuk DO, Berman E, Dunea G. Acute fatal hyperaluminemic encephalopathy in undialyzed and recently dialyzed uremic patients. Trans Am Soc Artif Intern Organs. 1986; 32:171–6.Google Scholar
  14. 14.
    Salusky IB, Coburn JW, Foley J, Nelson P, Fine RN. Effects of oral calcium carbonate on control of serum phosphorus and changes in plasma aluminum levels after discontinuation of aluminum-containing gels in children receiving dialysis. J Pediatr. 1986;108:767–70.PubMedCrossRefGoogle Scholar
  15. 15.
    Alon U, Davidai G, Bentur L, Berant M, Better OS. Oral calcium carbonate as phosphate-binder in infants and children with chronic renal failure. Miner Electrolyte Metab. 1986;12:320–5.PubMedGoogle Scholar
  16. 16.
    Andreoli SP, Dunson JW, Bergstein JM. Calcium carbonate is an effective phosphorus binder in children with chronic renal failure. Am J Kidney Dis. 1987;9:206–10.PubMedGoogle Scholar
  17. 17.
    Founder A, Moriniere PH, Sebert JL, Dkhissi H, Atik A, Leflon P, Renaud H, Gueris J, Gregoire I, Idrissi A, Garabedian M. Calcium carbonate, an aluminum-free agent for control of hyperphos-phatemia, hypocalcemia and hyperparathyroidism in uremia. Kidney Int. 1986;29: S115–19.Google Scholar
  18. 18.
    Indridason OS, Quarles LD. Comparison of treatments for mild secondary hyperparathyroidism in hemodialysis patients. Kidney Int. 2000;57:282–92.PubMedCrossRefGoogle Scholar
  19. 19.
    Salusky IB, Kuizon BD, Belin T, Ramirez JA, Gales B, Segre GV, Goodman WG. Intermittent calcitriol therapy in secondary hyperparathyroidism: a comparison between oral and intraperitoneal administration. Kidney Int. 1998;54:907–14.PubMedCrossRefGoogle Scholar
  20. 20.
    Salusky IB, Goodman WG. Adynamic renal osteodystrophy: is there a problem? J Am Soc Nephrol. 2001;12:1978–85.PubMedGoogle Scholar
  21. 21.
    Wallot M, Bonzel KE, Winter A, Georger B, Lettgen B, Bald M. Calcium acetate versus calcium carbonate as oral phosphate binder in pediatric and adolescent hemodialysis patients. Pediatr Nephrol. 1996;10:625–30.PubMedCrossRefGoogle Scholar
  22. 22.
    Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky IB. Coronary artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med. 2000;342:1478–83.PubMedCrossRefGoogle Scholar
  23. 23.
    Guerin AP, London GM, Marchais SJ, Metivier F. Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant. 2000;15:1014–21.PubMedCrossRefGoogle Scholar
  24. 24.
    Block GA, Port FK. Re-evaluation of risks associated with hyperphosphatemia and hyperparathyroidism in dialysis patients: recommendations for a change in management. Am J Kidney Dis. 2000;35:1226–37.PubMedCrossRefGoogle Scholar
  25. 25.
    Goodman WG, Coburn JW, Ramirez JA, Slatopolsky E, Salusky IB. Renal osteodystrophy in adult and pediatric patients. In: Favus M, editor. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. New York: Raven Press, pp. 304–23.Google Scholar
  26. 26.
    Schaefer K, Scheer J, Asmus G, Umlauf E, Hagemann J, von Herrath D. The treatment uraemic hyperphosphataemia with calcium acetate and calcium carbonate: a comparative study. Nephrol Dial Transplant. 1991;6:171–5.CrossRefGoogle Scholar
  27. 27.
    Cushner HM, Copley JB, Lindberg JS, Foulks CJ. Calcium citrate, a nonaluminum-containing phosphate-binding agent for treatment of CRF. Kidney Int. 1988;33:95–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Birck R, Zimmermann E, Wassmer S, Nowack R, van der Woude FJ. Calcium ketoglutarate versus calcium acetate for treatment of hyperphosphatemia in patients on maintenance hemodialysis: a cross-over study. Nephrol Dial Transplant. 1999;14:1475–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Raggi P. Effects of excess calcium load on the cardiovascular system measured with electron beam tomography in end-stage renal disease. Nephrol Dial Transplant. 2002;17:332–5.PubMedCrossRefGoogle Scholar
  30. 30.
    Milliner DS, Zinsmeister AR, Lieberman E, Landing B. Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int. 1990;38:931–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Ibels LS, Alfrey AC, Huffer WE, Craswell PW, Anderson JT, Weil R3. Arterial calcification and pathology in uremic patients undergoing dialysis. Am J Med. 1979;66:790–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Schwarz U, Buzello M, Ritz E, Stein G, Raabe G, Wiest G, Mall G, Amann K. Morphology of coronary atherosclerotic lesions in patients with end-stage renal failure. Nephrol Dial Transplant. 2000;15:218–23.PubMedCrossRefGoogle Scholar
  33. 33.
    Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F. Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation. 2002;106:100–105.PubMedCrossRefGoogle Scholar
  34. 34.
    Slatopolsky E, Burke SK, Dillon MA. RenaGel, a nonabsorbed calcium-and aluminum-free phosphate binder, lowers serum phosphorus and parathyroid hormone. The RenaGel Study Group. Kidney Int. 1999;55:299–307.PubMedCrossRefGoogle Scholar
  35. 35.
    Bleyer AJ, Burke SK, Dillon M, Garrett B, Kant KS, Lynch D, Rahman SN, Schoenfeld P, Teitelbaum I, Zeig S, Slatopolsky E. A comparison of the calcium-free phosphate binder sevelamer hydrochloride with calcium acetate in the treatment of hyperphosphatemia in hemodialysis patients. Am J Kidney Dis. 1999;33:694–701.PubMedCrossRefGoogle Scholar
  36. 36.
    Chertow GM, Burke SK, Dillon MA, Slatopolsky E. Long-term effects of sevelamer hydrochloride on the calcium X phosphate product and lipid profile of haemodialysis patients. Nephrol Dial Transplant. 1999;14:2709–14.CrossRefGoogle Scholar
  37. 37.
    Chertow GM, Burke SK, Raggi P. Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients. Kidney Int. 2002;62:245–52.PubMedCrossRefGoogle Scholar
  38. 38.
    Mahdavi H, Kuizon BD, Gales B, Wang HJ, Elashoff R, Salusky IB. Sevelamer hydrochloride an effective phosphate binder in children treated with dialysis. Pediatr Nephrol. 2003; in press.Google Scholar
  39. 39.
    O’Donovan R, Baldwin D, Hammer M, Moniz C, Parsons V. Substitution of aluminum salts by magnesium salts in control of dialysis hyperphosphatemia. Lancet 1986;1:880–2.PubMedCrossRefGoogle Scholar
  40. 40.
    Hergesell O, Ritz E. Phosphate binders on iron basis: a new perspective? Kidney Int. 1999;73(Suppl):S42–5.CrossRefGoogle Scholar
  41. 41.
    Hergesell O, Ritz E. Stabilized polynuclear iron hydroxide is an efficient oral phosphate binder in uraemic patients. Nephrol Dial Transplant. 1999;14:863–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Graff L, Burnel D. A possible non-aluminum oral phosphate binder? A comparative study on dietary phosphate absorption. Rec Prog Hormone Res. 1995;89:373–88.Google Scholar
  43. 43.
    Sherrard DJ, Baylink DJ, Wergedal JE, Maloney NA. Quantitative histological studies on the pathogenesis of uremic bone disease. J Clin Endocrinol Metab. 1974;39:119–35.PubMedCrossRefGoogle Scholar
  44. 44.
    Salusky IB, Coburn JW, Brill J, Foley J, Slatopolsky E, Fine RN, Goodman WG. Bone disease in pediatric patients undergoing dialysis with CAPD or CCPD. Kidney Int. 1988;33:975–82.PubMedCrossRefGoogle Scholar
  45. 45.
    Malluche HH, Monier-Faugere MC. The role of bone biopsy in the management of patients with renal osteodystrophy. J Am Soc Nephrol. 1994;4:1631–42.PubMedGoogle Scholar
  46. 46.
    Quarles LD, Lobaugh B, Murphy G. Intact parathyroid hormone overestimates the presence and severity of parathyroid-mediated osseous abnormalities in uremia. J Clin Endocrinol Metab. 1992;75:145–50.PubMedCrossRefGoogle Scholar
  47. 47.
    Nussbaum SR, Zahradnik RJ, Lavigne JR, Brennan GL, Nozawa-Ung C, Kim LY, Keutmann T, Wang CA, Potts JT Jr, Segre GV. Highly sensitive two-site immunoradiometric assay of parathyrin, and its clinical utility in evaluating patients with hypercalcemia. Clin Chem. 1987;33:1364–7.PubMedGoogle Scholar
  48. 48.
    Lepage R, Roy L, Brossard JH, Rousseau L, Dorais C, Lazure C, D’Amour P. A non-(l-84) circulating parathyroid hormone (PTH) fragment interferes significantly with intact PTH commercial assay measurements in uremic samples. Clin Chem. 1998;44:805–9.PubMedGoogle Scholar
  49. 49.
    Brossard JH, Cloutier M, Roy L, Lepage R, Gascon-Barre M, D’Amour P. Accumulation of a non-(l-84) molecular form of parathyroid hormone (PTH) detected by intact PTH assay in renal failure: importance in the interpretation of PTH values. J Clin Endocrinol Metab. 1996;81:3923–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Brossard JH, Yamamoto LN, D’Amour P. Parathyroid hormone metabolites in renal failure: bioactivity and clinical implications. Semin Dial. 2002;15:196–201.PubMedCrossRefGoogle Scholar
  51. 51.
    John MR, Goodman WG, Gao P, Cantor TL, Salusky IB, Jüppner H. A novel immunoradiometric assay detects full-length human PTH but not amino-terminally truncated fragments: implications for PTH measurements in renal failure. J Clin Endocrinol Metab. 1999;84:4287–90.PubMedCrossRefGoogle Scholar
  52. 52.
    Slatopolsky E, Finch J, Clay P, Martin D, Sicard G, Singer G, Gao P, Cantor TL, Dusso A. A novel mechanism for skeletal resistance in uremia. Kidney Int. 2000;58:753–61.PubMedGoogle Scholar
  53. 53.
    Gao P, Scheibel S, D’Amour P, John MR, Rao DS, Schmidt-Gayk H, Cantor TL. Development of a novel immunoradiometric assay exclusively for biologically active whole parathyroid hormone 1-84: Implications for improvement of accurate assessment of parathyroid function. J Bone Miner Res. 2001;16:605–14.PubMedCrossRefGoogle Scholar
  54. 54.
    Monier-Faugere MC, Geng Z, Mawad H, Friedler RM, Gao P, Cantor TL, Malluche HH. Improved assessment of bone turnover by the PTH-(l-84)/large C-PTH fragments ratio in ESRD patients. Kidney Int. 2001;60:1460–8.PubMedCrossRefGoogle Scholar
  55. 55.
    Coen G, Bonucci E, Ballanti P, Balducci A, Calabria S, Nicolai GA, Fischer MS, Lifrieri F, Manni M, Morosetti M, Moscaritolo E, Sardella D. PTH 1-84 and PTH “7-84” in the noninvasive diagnosis of renal bone disease. Am J Kidney Dis. 2002;40:348–54.PubMedCrossRefGoogle Scholar
  56. 56.
    Salusky IB, Goodman WG, Kuizon BD, Lavigne JR, Zahranik RJ, Gales B, Wang HJ, Elashoff RM, Juppner H. Similar predictive value of bone turnover using first-and second-generation immunometric PTH assays in pediatric patients treated with peritoneal dialysis. Kidney Int. 2003;63:1801–8.PubMedCrossRefGoogle Scholar
  57. 57.
    Hodsman AB, Sherrard DJ, Alfrey AC, Ott SM, Brickman AS, Miller NL, Maloney NA, Coburn JW. Bone aluminum and histomorphometric features of renal osteodystrophy. J Clin Endocrinol Metab. 1982;54:539–46.PubMedCrossRefGoogle Scholar
  58. 58.
    Chesney RW, Moorthy AV, Eisman JA, Tax DK, Mazess RB, DeLuca HF. Increased growth after long-term oral 1,25-vitamin D3 in childhood renal osteodystrophy. N Engl J Med. 1978;298:238–42.PubMedCrossRefGoogle Scholar
  59. 59.
    Goodman WG, Salusky IB. Evolution of secondary hyperparathyroidism during daily oral calcitriol therapy in pediatric renal osteodystrophy. Contrib Nephrol. 1991;90:189–95.PubMedGoogle Scholar
  60. 60.
    Slatopolsky E, Weerts C, Thielan J, Horst RL, Harter H, Martin KJ. Marked suppression of secondary hyperparathyroidism by intravenous administration of 1,25-dihydroxycholecalciferol in uremic patients. J Clin Invest. 1984;74:2136–43.PubMedCrossRefGoogle Scholar
  61. 61.
    Quarles LD, Yohay DA, Carroll BA, Spritzer CE, Minda SA, Bartholomay D, Lobaugh BA. Prospective trial of pulse oral versus intravenous calcitriol treatment of hyperparathyroidism in ESRD. Kidney Int. 1994;45:1710–21.PubMedCrossRefGoogle Scholar
  62. 62.
    Levine BS, Song M. Pharmacokinetics and efficacy of pulse oral versus intravenous calcitriol in hemodialysis patients. J Am Soc Nephrol. 1996;7:488–96.PubMedGoogle Scholar
  63. 63.
    Martin KJ, Bullal HS, Domoto DT, Blalock S, Weindel M. Pulse oral calcitriol for the treatment of hyperparathyroidism in patients on continuous ambulatory peritoneal dialysis: Preliminary observations. Am J Kidney Dis. 1992;19:540–5.PubMedGoogle Scholar
  64. 64.
    Fischer ER, Harris DC. Comparison of intermittent oral and intravenous calcitriol in hemodialysis patients with secondary hyperparathyroidism. Clin Nephrol. 1993;40:216–20.PubMedGoogle Scholar
  65. 65.
    Goodman WG, Ramirez JA, Belin TR, Chon Y, Gales B, Segre GV, Salusky IB. Development of adynamic bone in patients with secondary hyperparathyroidism after intermittent calcitriol therapy. Kidney Int. 1994;46:1160–66.PubMedCrossRefGoogle Scholar
  66. 66.
    Schmitt CP, Huber D, Mehls O, Maiwald J, Stein G, Veldhuis JD, Ritz E, Schaefer F. Altered instantaneous and calcium-modulated oscillatory PTH secretion patterns in patients with secondary hyperparathyroidism. J Am Soc Nephrol. 1998;9:1832–44.PubMedGoogle Scholar
  67. 67.
    Andress DL, Norris KC, Coburn JW, Slatopolsky EA, Sherrard DJ. Intravenous calcitriol in the treatment of refractory osteitis fibrosa of chronic renal failure. N Engl J Med. 1989;321: 274–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Nguyen-Yamamoto L, Rousseau L, Brossard JH, Lepage R, Gao P, Cantor T, D’Amour P. Origin of parathyroid hormone (PTH) fragments detected by intact-PTH assays. Eur J Endocrinol. 2002;147:123–31.PubMedCrossRefGoogle Scholar
  69. 69.
    Nguyen-Yamamoto L, Rousseau L, Brossard JH, Lepage R, D’Amour P. Synthetic carboxyl-terminal fragments of parathyroid hormone (PTH) decrease ionized calcium concentration in rats by acting on a receptor different from the PTH/PTH-related peptide receptor. Endocrinology. 2001;142:1386–92.PubMedCrossRefGoogle Scholar
  70. 70.
    Kuizon BD, Goodman WG, Jüppner H, Boechat I, Nelson P, Gales B, Salusky IB. Diminished linear growth during treatment with intermittent calcitriol and dialysis in children with chronic renal failure. Kidney Int. 1998;53:205–11.PubMedCrossRefGoogle Scholar
  71. 71.
    Denda M, Finch J, Brown AJ, Nishii Y, Kubodera N, Slatopolsky E. 1,25-dihydroxyvitamin D3 and 22-oxacalcitriol prevent the decrease in vitamin D receptor content in the parathyroid glands of uremic rats. Kidney Int. 1996;50:34–9.PubMedCrossRefGoogle Scholar
  72. 72.
    Hirata M, Katsumata K, Masaki T, Koike N, Endo K, Tsunemi K, Ohkawa H, Kurokawa K, Fukagawa M. 22-Oxacalcitriol ameliorates high-turnover bone and marked osteitis fibrosa in rats with slowly progressive nephritis. Kidney Int. 1999;56:2040–7.PubMedCrossRefGoogle Scholar
  73. 73.
    Monier-Faugere MC, Geng Z, Friedler RM, Qi Q, Kubodera N, Slatopolsky E, Malluche HH. 22-oxacalcitriol suppresses secondary hyperparathyroidism without inducing low bone turnover in dogs with renal failure. Kidney Int. 1999;55:821–32.PubMedCrossRefGoogle Scholar
  74. 74.
    Kurokawa K, Akizawa T, Suzuki M, Akiba T, Ogata E, Slatopolsky E. Effect of 22-oxacalcitriol on hyperparathyroidism of dialysis patients: results of preliminary study. Nephrol Dial Transplant. 1996;11:121–4.PubMedCrossRefGoogle Scholar
  75. 75.
    Tsukamoto Y, Hanaoka M, Matsuo T, Saruta T, Nomura M, Takahashi Y. Effect of 22-oxacalcitriol on bone histology of hemodialyzed patients with severe secondary hyperparathyroidism. Am J Kidney Dis. 2000;35:458–64.PubMedCrossRefGoogle Scholar
  76. 76.
    Sjüden G, Smith C, Lindgren JU, DeLuca HF. 1 α-hydroxy vitamin D2 is less toxic than Iα-hydroxvitamin D3 in the rat. Proc Soc Exp Biol Med. 1985;178:432–6.Google Scholar
  77. 77.
    Tan AU Jr, Levine BS, Mazess RB, Kyllo DM, Bishop CW, Knutson JC, Kleinman KS, Coburn JW. Effective suppression of parathyroid hormone by 1 alpha-hydroxy-vitamin D2 in hemodialysis patients with moderate to severe secondary hyperparathyroidism. Kidney Int. 1997; 51:317–23.PubMedCrossRefGoogle Scholar
  78. 78.
    Frazao J, Chesney RW, Coburn JW. Intermittent oral lalpha-hydroxyvitamin D2 is effective and safe for the suppression of secondary hyperparathyroidism in haemodialysis patients. lalphaD2 Study Group. Nephrol Dial Transplant. 1998;13(Suppl 3):68–72.PubMedCrossRefGoogle Scholar
  79. 79.
    Slatopolsky E, Finch J, Ritter C, Denda M, Morrissey J, Brown A, DeLuca H. A new analog of calcitriol, 19-nor-l,25-(OH)2D2, suppresses parathyroid hormone secretion in uremic rats in the absence of hypercalcemia. Am J Kidney Dis. 1995;26:852–60.PubMedCrossRefGoogle Scholar
  80. 80.
    Finch JL, Brown AJ, Slatopolsky E. Differential effects of 1,25-dihydroxy-vitamin D3 and 19-nor-l,25-dihydroxy-vitamin D2 on calcium and phosphorus resorption in bone. J Am Soc Nephrol. 1999;10:980–5.PubMedGoogle Scholar
  81. 81.
    Martin KJ, Gonzalez EA, Gellens M, Hamm LL, Abboud H, Lindberg J. 19-Nor-l-α-25-dihydroxyvitamin D2 (paricalcitol) safely and effectively reduces the levels of intact parathyroid hormone in patients on hemodialysis. J Am Soc Nephrol. 1998;9:1427–32.PubMedGoogle Scholar
  82. 82.
    Llach F, Keshav G, Goldblat MV, Lindberg JS, Sadler R, Delmez J, Arruda J, Lau A, Slatopolsky E. Suppression of parathyroid hormone secretion in hemodialysis patients by a novel vitamin D analogue: 19-nor-1,25-dihydroxyvitamin D2. Am J Kidney Dis. 1998;32:S48–54.PubMedCrossRefGoogle Scholar
  83. 83.
    Sprague SM, Lerma E, McCormmick D, Abraham M, Batlle D. Suppression of parathyroid hormone secretion in hemodialysis patients: comparison of paricalcitol with calcitriol. Am J Kidney Dis. 2001; 38:S51–6.PubMedCrossRefGoogle Scholar
  84. 84.
    Wada M, Furuya Y, Sakiyama J, Kobayashi N, Miyata S, Ishii H, Nagano N. The calcimimetic compound NPS R-568 suppresses parathyroid cell proliferation in rats with renal insufficiency. Control of parathyroid cell growth via a calcium receptor. J Clin Invest. 1997;100:2977–83.PubMedCrossRefGoogle Scholar
  85. 85.
    Wada M, Nagano N, Furuya Y, Chin J, Nemeth EF, Fox J. Calcimimetic NPS R-568 prevents parathyroid hyperplasia in rats with severe secondary hyperparathyroidism. Kidney Int. 2000;57:50–8.PubMedCrossRefGoogle Scholar
  86. 86.
    Antonsen JE, Sherrard DJ, Andress DL. A calcimimetic agent acutely suppresses parathyroid hormone levels in patients with chronic renal failure. Rapid communication. Kidney Int. 1998;53:223–7.PubMedCrossRefGoogle Scholar
  87. 87.
    Goodman WG, Hladik GA, Turner SA, Blaisdell PW, Goodkin DA, Liu W, Barri YM, Cohen RM, Coburn JW. The calcimimetic agent AMG 073 lowers plasma parathyroid hormone levels in hemodialysis patients with secondary hyperparathyroidism. J Am Soc Nephrol. 2002;13: 1017–24.PubMedGoogle Scholar
  88. 88.
    Goodman WG. Calcimimetic agents and secondary hyperparathyroidism: treatment and prevention. Nephrol Dial Transplant. 2002;17:204–7.PubMedCrossRefGoogle Scholar
  89. 89.
    Chang W, Tu C, Chen TH, Komuves L, Oda Y, Pratt SA, Miler S, Shoback D. Expression and signal transduction of calcium-sensing receptors in cartilage and bone. Endocrinology. 1999;140:5883–93.PubMedCrossRefGoogle Scholar
  90. 90.
    Atsumi K, Kushida K, Yamazaki K, Shimizu S, Ohmura A, Inoue T. Risk factors for vertebral fractures in renal osteodystrophy. Am J Kidney Dis. 1999;33:287–3.PubMedCrossRefGoogle Scholar
  91. 91.
    Parfrey PS, Foley RN. The clinical epidemiology of cardiac disease in chronic renal failure. J Am Soc Nephrol. 1999;10:1606–15.PubMedGoogle Scholar
  92. 92.
    Coco M, Rush H. Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone. Am J Kidney Dis. 2000;36:1115–21.PubMedCrossRefGoogle Scholar
  93. 93.
    Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension. 2001;38:938–42.PubMedCrossRefGoogle Scholar
  94. 94.
    Kurz P, Monier-Faugere MC, Bognar B, Werner E, Roth P, Vlachojannis J, Malluche HH. Evidence for abnormal calcium homeostasis in patients with adynamic bone disease. Kidney Int. 1994;46:855–61.PubMedCrossRefGoogle Scholar
  95. 95.
    Hercz G, Pei Y, Greenwood C, Manuel A, Saiphoo C, Goodman WG, Segre GV, Fenton S, Sherrard DJ. Aplastic osteodystrophy without aluminum: the role of “suppressed” parathyroid function. Kidney Int. 1993;44:860–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2004

Authors and Affiliations

  • I. B. Salusky

There are no affiliations available

Personalised recommendations