MANAGEMENT OF RENAL OSTEOPATHY IN CHRONIC DIALYSIS PATIENTS

During the past decade considerable progress has been made in the fiel d of calcium metabolism associated with chronic renal failure. The mai n factor influencing the pathophysiology of calcium homeostasis is its dependence on parathyroid hormone and active vitamin D metabolites. A mong several new diagnostic tools, and to establish the diagnosis of r enal osteodystrophy, only the measurement of i-PTH activity has any cl inical relevance. The main goal in treating renal osteodystrophy is th e lowering of PTH activity by correcting hyperphosphatemia and adminis tration of calcitriol given either orally or intravenously. Furthermor e, the need to lower tile calcium concentration in the dialysate durin g calcitriol treatment is demonstrated. The clinical significance of a dynamic osteodystrophy is still unclear.