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bone metabolism

Phosphorous Binder Equivalent Dose

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…

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Bone pain after transplant

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…

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Re-Evaluating the Ca x P Product

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…

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Sensipar for APKD?

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…

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Lithium-Induced Hyperparathyroidism

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…

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Vitamin D Basics

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…

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Adynamic bone disease

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…

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DCOR Trial

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)….

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