Bone disease in chronic renal failure and its modern therapy

Česká verzia

Authors: S. Dusilová Sulková
Authors place of work: Klinika nefrologie, Transplantační centrum IKEM Praha, přednosta prof. MUDr. Ondřej Viklický, CSc.
Published in the journal: Vnitř Lék 2011; 57(7&8): 620-625
Category: 136th internal medicine day, XXIV. Vanýskův den, Brno 2011

Summary

Renal bone disease is one of the most serious complications of chronic renal failure. Secondary hyperparathyreosis is decisive for its pathogenesis. Current prevention and treatment emphasises pathogenetic and clinical interrelationships between bone tissue involvement and cardiovascular complications (CKD-MBD, bone and venous involvement associated with chronic renal disease). The treatment should first correct hyperphosphatemia and, subsequently, hyperreactivity of parathyroid glands through vitamin D receptor (VDR) and calcium receptor (CaR) modulation. Three groups of drugs play a fundamental role here (GIT phosphate binders, calcimimetics and vitamin D receptor activators). Certain other therapeutic approaches are used in some specific situations such as, among others, refractory hyperparathyreosis or calciphylaxis.

Key words:
chronic renal failure – bone disease – secondary hyperparathyreosis

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