Ever encountered this situation? You’re going about your daily business and discover that one of your patients on hemodialysis has an elevated phosphorous. You skim through the list of prerequisites and see that yes, the nutritionist has been…
Keeping the bone theme: A 50-year-old woman with ESRD secondary to PKD underwent a living related-kidney transplant one-month prior. At clinic visit, she was complaining of severe throbbing pain in her hands and feet. The pain was worse…
In a recent survey of 630 bone biopsy samples from patients with CKD stage 5 on dialysis, bone turnover was low in 52%, normal in 21% and high in 27% of biopsies. Defective mineralization was found in only…
At a recent meeting on bone biology, several talks were devoted to a new class of drugs targeting osteoporosis. Since these drugs are antibodies and thus not cleared by the kidney, I paid close attention, as they have…
Heard an excellent presentation at our Renal Grand Rounds today by Dr. Charles O’Neill of Emory University, regarding the process of pathologic calcification in CKD/ESRD patients. One of the points I took away from this talk is that…
Following on the heels of studies showing a potentially beneficial effect for vasopressin receptor antagonists and rapamycin in the treatment of renal cystic disorders, an article in this month’s JASN by Gattone et al suggests another class of…
Lithium, a very effective medication in the treatment of bipolar disorder, has a variety of well-documented renal side effects, including interstitial nephritis and nephrogenic diabetes insipidus. A less well-recognized complication is an increased prevalence of hyperparathyroidism in chronic…
Sometimes the formulations of vitamin D can get confusing. Here’s a few key points: 1. The terms “vitamin D2” and “vitamin D3” do not refer to the hydroxylation status of vitamin D–either D2 or D3 can exist in…
Adynamic bone disease is being increasingly recognized as the most common form of renal osteodystrophy. It is characterized by the reduced synthesis of bone matrix due to decreased osteoblastic and osteoclastic activity. Adynamic bone disease is distinct from…
The DCOR Trial was a Genzyme-funded randomized control trial–somebody recently told me the largest ever conducted in a dialysis population–designed to compare the phosphate binder sevelamer (Renagel) with Ca-containing phosphate binders (calcium acetate a.k.a. Phoslo or calcium carbonate)….
