| Theme |
Characteristic Problems in Managing Female Dialysis Patients |
| Title |
Abnormality of bone metabolism in hemodialyzed women |
| Author |
Eriko Kinugasa |
Department of Internal Medicine, Showa University, Northern Yokohama Hospital |
| Author |
Hidetoshi Ito |
Department of Internal Medicine, Showa University, Northern Yokohama Hospital |
| Author |
Akiko Sakashita |
Department of Internal Medicine, Showa University, Northern Yokohama Hospital |
| [ Summary ] |
Bone metabolism in female hemodialysis patients is complicated because of the coexistence of renal osteodystrophy (ROD) and metabolic bone disease originating from estrogen deficiency, both of which act to prevent loss of bone minerals. The most significant problem related to this condition is that there is increased risk of bone fractures with this abnormal bone metabolism, which influences the quality of life and the future prognosis for these patients. At the present time, the therapeutic approach mainly directs us in treatment of ROD, with such things as proper control of serum calcium, phosphorus and parathyroid hormone, along with activated vitamin D and calcium salts. The long term safety of hormone replacement therapy in women receiving hemodialysis is not certain at this time. The clinical usefulness of other therapeutic agents, which are generally used for treatment of osteoporosis, is not obvious in hemodialysis patients. The avoidance of risk factors related to osteoporosis, such as immobilization, malnutrition, smoking and alcohol, is also important to prevent further loss of bone minerals. Finally, this condition should be considered in relation to therapeutic intervention from the start of the pre-dialysis period. |