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CKD-RENAL OSTEODYSTROPHY

Nephrology

CKD-RENAL OSTEODYSTROPHY

TYPES
1. Osteitis fibrosa cystica due to secondary hyperparathyroidism (high bone-turnover disorder)
2. Adynamic bone disease due to over-suppression of parathyroid hormone release (low bone-turnover disorder)
3. Osteomalacia (low bone-turnover disorder associated with unmineralized bone)

INX & MANAGEMENT
4. Clinical findings: asymptomatic, but may develop bone pain and have increased risk of fractures.
5. Radiographs show subperiosteal bone resorption in the distal clavicle and the phalanges.
6. Treat this by following intact PTH (iPTH) levels.
7. Maintain serum Ca and PO 4 levels using phosphate binders, activated Vit D/analogs (paricalcitol, doxercalciferol), +/- calcimimetics (cinacalcet).


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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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