| Theme |
Renal Osteodystrophy, Up-To-Date |
| Title |
Paradigm shifts in ROD therapy |
| Author |
Keitaro Yokoyama |
Department of Internal Medicine, Division of Nephrology and Hypertension, Tokyo Jikei University School of Medicine |
| Author |
Yoshindo Kawaguchi |
Jikei University School of Medicine / Kanagawa Prefectural Hospital Affiliated with Nurses Training School |
| [ Summary ] |
In 2003, the National Kidney Foundation introduced the “K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease”. One of the most important characteristics of the guidelines is that abnormalities of calcium/phosphorus metabolism are not assessed merely in relation to bone disease, but to vascular calcification and the prevalence of vascular events during long-term renal replacement therapy. Since the paradigms of renal osteodystrophy (ROD) management have shifted dramatically, Japanese nephrologists should reconsider the stratagies for ROD management. In fact, we have administered Ca containing phosphate binders to control hyperphospliatemia in ESRD patients involving a risk of vascular calcification. We should manage ROD and ectopic calcification in terms of that we can use new agents (sevelamer, calcimetics) for ROD therapy without positive calcium balance. |