| [ Summary ] |
Renal osteodystrophy is one of the major complications with end-stage renal disease. The earliest hypothesis for diagnosis of renal osteodystrophy is the “trade-off hypothesis”, which shows the adaptations of the kidnies to decreases in serum phosphorus levels and raises in serum calcium levels by elevated parathyroid hormone (PTH) levels, which stimulate phosphorus excretion. Furthermore, new mechanisms have been suggested. In secondary hyperparathyroidism, the parathyroid glands continue to produce PTH, and although they become hypertrophic, the number and sensitivity of their vitamin D receptors decreases, causing the glands to become even less responsive to vitamin D and calcium. In addition to calcitriol and calcium, phosphorus also directly modifies the level of serum PTH. This article describes biomarkers for renal osteodystrophy. |