The investigation and treatment of renal osteodystrophy

Skeletal demineralisation was measured for two years in 16 patients on maintenance haemodialysis; the technique employed was neutron activation analysis of a hand. The magnesium concentration of the dialysate was increased in six of the patients; oral calcium carbonate was administered to seven patients and 1-alpha-hydroxycholecalciferol, a potent vitamin-D analogue was supplied to a further three patients. An increase in skeletal calcium content of a hand was noted in the groups of patients receiving supplementary calcium and 1-alpha-hydroxycholecalciferol. It is concluded that 1-alpha-hydroxycholecalciferol appears to be effective therapy for renal osteodystropy, that oral calcium supplements may promote skeletal remineralisation and that supplementary magnesium therapy may reduce the progressive losses of skeletal calcium from some patients on maintenance haemodialysis.