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CKD-ADYNAMIC BONE DISEASE

Nephrology

CKD-ADYNAMIC BONE DISEASE

1. Low bone turnover state accompanied by reduced bone formation.

2. The cause is oversuppression of PTH by phosphorous binders and concomitant prescription of vitamin D analogs.

3. Most patients with adynamic bone disease are asymptomatic, but they can have fractures and hypercalcemia.

4. Diagnose by observing an intact PTH level of< I 00 pg/mL in a patient with CKD. ALP not elevated.

5. Treat by reducing amount of vitamin D analog and calcium-based phosphate binders (or use non-calcium based binders).


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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