Related Experiment Video

Updated: Aug 21, 2026

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
11:30

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro

Published on: June 2, 2022

Management of calcium and bone abnormalities in hemodialysis patients

Hirotoshi Morii1, Tayuki Inoue, Takaaki Nishijima

  • 1Osaka City University, Osaka, Japan.

Seminars in Nephrology
|October 19, 2004
PubMed

Insights

Chronic renal failure causes calcium abnormalities like hyperphosphatemia and hypocalcemia, impacting hemodialysis patient survival. Treatments focus on managing parathyroid hormone, phosphate, and calcium levels, with new vitamin D analogs and phosphate binders offering therapeutic options.

Area of Science:

  • Nephrology
  • Endocrinology
  • Mineral Metabolism

Background:

  • Chronic renal failure (CRF) is associated with complex calcium-bone abnormalities.
  • Key features include hyperphosphatemia, hypocalcemia, secondary hyperparathyroidism, and altered vitamin D metabolism.
  • These derangements significantly impact the survival and quality of life for hemodialysis patients.

Purpose of the Study:

  • To review the calcium abnormalities in chronic renal failure.
  • To discuss the implications of hyperparathyroidism and hypoparathyroidism in hemodialysis patients.
  • To outline current and emerging therapeutic strategies for managing these mineral and bone disorders.

Main Methods:

  • Literature review of studies on calcium metabolism in chronic kidney disease.
  • Analysis of the role of parathyroid hormone (PTH) and vitamin D in CRF.
  • Examination of novel therapeutic agents, including vitamin D analogs and phosphate binders.

Main Results:

  • Hyperphosphatemia, hypocalcemia, and hyperparathyroidism are prevalent in CRF.
  • Secondary hyperparathyroidism is a significant risk factor for mortality in hemodialysis patients.
  • Newer vitamin D analogs (e.g., maxacalcitol, falecalcitriol) and phosphate binders (e.g., sevelamer) offer improved management options.

Conclusions:

  • Effective management of calcium-related abnormalities is crucial for CRF patients.
  • Controlling parathyroid hormone secretion, hyperphosphatemia, and hypocalcemia are key treatment goals.
  • Advancements in vitamin D therapy and phosphate binders provide better strategies for addressing mineral and bone disease in renal failure.

Related Concept Videos

Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Skeleton and Calcium Homeostasis01:21

Skeleton and Calcium Homeostasis

Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Peritoneal Dialysis III: Nursing Management01:25

Peritoneal Dialysis III: Nursing Management

Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...