Calcium and Phosphate Metabolism Management in Chronic Renal by Chen H. Hsu

By Chen H. Hsu

When the kidney fails its meant project to regulate the body’s waste items, physicians needs to practice multi-level and simultaneous changes to copy kidney functionality. The administration of the body’s absorption, reabsorption, usage and excretion of calcium and phosphate calls for consistent superb tuning. This publication offers an outline of the cutting-edge medical and uncomplicated technological know-how elements of irregular calcium and phosphate metabolism and its management.

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These limitations led to the development of non-calcium-based agents. The polymer-based binding resin sevelamer hydrochloride, a rare earth element salt, and lanthanum carbonate, comprise the newest and the third generation of phosphorus binders. This third generation of phosphorus binders offers nephrologists new strategies to control dietary phosphate absorption and may prove to be more effective in controlling secondary hyperparathyroidism. Historically, other alternatives have included magnesium and iron salts.

Mechanisms through which parathyroid hormone mediates its deleterious effects on organ function in uremia. Semin Nephrol 1994;14(3):219–31. Chapter 3 Pathogenesis and Management of Secondary Hyperparathyroidism Krishna R. Polu and Ajay K. Singh I. 2 Hyperphosphatemia, hypocalcemia, and vitamin D deficiency all play a role in the development of secondary hyperparathyroidism (SHPT), and more recent data suggest that the calcium-sensing receptors on the parathyroid gland also contribute to the etiology of secondary hyperparathyroidism in patients with chronic kidney disease (CKD).

88 Therefore, controlling serum phosphate through dietary measures and phosphate binders remains a critical component of therapy in patients with chronic kidney disease. Unfortunately, current control of phosphorus in the dialysis population may be inadequate and underscores the need for a multifactorial approach by nephrologists and additional novel therapies. In an analysis of two large national, random, cross-sectional samples of hemodialysis patients receiving dialysis for at least 1 year, Block and colleagues found that 10% of patients had serum phosphate levels greater than 9 mg/dl and 30% had serum phosphate concentrations greater than 7 mg/dl.

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