Founding RN
Joined: 10 Jan 2003
Posts: 172
PostPosted: Sun Sep 07, 2003 10:08 am Post subject: Renal Osteodystrophy: Bone Disease in the ESRD Pt.
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>Renal Osteodystrophy is the name given to all bone diseases found in the ESRD patient.<
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>Cause:<
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>As renal function deteriorates, the ESRD patient loses the ability to excrete phosphate. Phosphates/ phosphorus must bind with calcium in order to be excreted from the body. As the phosphate ions increase in the body fluids, the serum calcium in those same body fluids, decrease. The Parathyroid Glands (PTH) are responsible in maintaining the balance between the calcium and phosphate/ phosphorus levels in the body. To do this the PTH gland then responds by increasing the production of the parathyroid hormone. (PTH)<
> This in turn causes calcium to be reabsorbed from the bone, which then results in the loss of bone density and strength. <
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>The kidneys also manufacture the form of vitamin D that is needed for normal bone metabolism. When the kidneys fail, there is a deficiency. <
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>Treatment:<
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>Dialysis does not fully correct this malfunction. There is a higher calcium level in the dialysate bath then in the body serum of the patient so each patient does get added calcium while on dialysis.<
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>Drugs such as Zemplar, Calcitrol, and Hectorol, which are Vitamin D analogs, given IV on dialysis, also help control this vicious cycle.<
>Taking your binders on a regular schedule also help keep this under control.<
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>Goal:<
>The goal is to keep enough calcium in your body fluids to facilitate the removal of excess phosphates/ phosphorus so that calcium is not lost from your bones.<
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