| Theme | How Can We Realize the Philosophy of Chronic Kidney Disease-Mineral and Bone Disorder? | |
|---|---|---|
| Title | Evaluation of clinical parameters other than Ca/P/PTH for medical examination of CKD-MBD patients | |
| Publish Date | 2010/01 | |
| Author | Yoshinari Tsuruta | Meiyo Clinic Hemodialysis Center |
| [ Summary ] | ALP is examined monthly because it may provide indications of bone turnover in CKD-MBD patients. Bone biopsies are not suitable for routine clinical practices because of their invasive nature. However, bone biopsies are the gold standard for diagnosis of MBD. This is particularly true when there is a large gap between bone metabolism markers, and serum P, or when Ca and/or intact PTH levels have been observed or when the patient is suspected to have osteomalacia. Bone densitometry is not useful for routine medical examination of CKD-MBD patients, since the risk of bone fractures and some types of bone lesions, including renal osteodystrophy (ROD), can not be predicted with this method. Vascular calcification is the highest risk condition related to cardiovascular disease. Therefore, examinations to observe vascular calcification are very important for treatment of CKD-MBD. |
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