Hyperphosphataemia as an important complication of chronic renal insufficiency and chronic renal failure, part 1 – etiopathogenesis, consequences and diagnostics

Česká verzia

Authors: J. Smržová
Authors place of work: Dialyzační a nefrologické oddělení Interní gastroenterologické kliniky Lékařské fakulty MU a FN Brno, pracoviště Bohunice přednosta prof. MUDr. Petr Dítě, DrSc.
Published in the journal: Vnitř Lék 2005; 51(3): 327-335
Category: Reviews

Summary

Abnormalities of calcium-phosphate metabolism start developing as early as in mild to moderate renal insufficiency when the glomerular filtration rate drops to 1 ml/s. As a result, the abnormalities can be found in up to 5% of population. The tendency towards the phosphate retention initiates a complicated cascade of disorders that ends in secondary hyperparathyroidism, renal bone disease and calcium-phosphate metabolism disturbances. The whole process leads to extraosseal calcifications, accelerated atherosclerosis and rise in mortality. Understanding pathogenetic mechanisms of calcium-phosphate metabolism disturbances well is vital for successful treatment that should be carried out by nephrologists, medical doctors and general practitioners. The aim of this paper is to summarise the up-to-date information related to etiopathogenesis and clinical consequences of calciumphosphate metabolism disturbances in renal insufficiency as well as possible diagnostic approaches. In the first part, the metabolism of phosphorus, calcium, vitamin D and parathormone in patients with normal renal function is briefly described. Further, the possible causes of hyperphosphataemia are analysed while special attention is paid to hyperphosphataemia in dialysed patients. A separate chapter is devoted to clinical consequences of hyperphosphataemia. Last, available diagnostic means are listed.

Key words:
hyperphosphataemia – renal bone disease – parathormone – renal insufficiency – haemodialysis – etiopathogenesis

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