Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Renal osteodystrophy in CAPD.

A J Hutchison1, A J Freemont, G A Lumb

  • 1Manchester Royal Infirmary, England.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 1, 1991
PubMed
Summary

Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) often have bone abnormalities. Using low calcium dialysis fluid and calcium carbonate can help avoid aluminum-containing phosphate binders and manage bone disease effectively.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Sarcoma in neurofibromatosis 2: case report and review of the literature.

Familial cancer·2018
Same author

Muscle regeneration following repair of the rotator cuff.

The bone & joint journal·2016
Same author

Qualitative grading of disc degeneration by magnetic resonance in the lumbar and cervical spine: lack of correlation with histology in surgical cases.

British journal of neurosurgery·2016
Same author

Potential role of the posterior cruciate ligament synovio-entheseal complex in joint effusion in early osteoarthritis: a magnetic resonance imaging and histological evaluation of cadaveric tissue and data from the Osteoarthritis Initiative.

Osteoarthritis and cartilage·2014
Same author

The pathogenesis of degeneration of the intervertebral disc and emerging therapies in the management of back pain.

The Journal of bone and joint surgery. British volume·2012
Same author

Radiograms showing Absence of Right Frontal Sinus.

Proceedings of the Royal Society of Medicine·2009

Area of Science:

  • Nephrology
  • Bone Metabolism
  • Mineral and Bone Disorders

Background:

  • Dialysis patients frequently present with histological bone abnormalities, categorized as high or low turnover bone disease.
  • Low turnover aplastic disease, previously linked to aluminum, can occur independently of aluminum accumulation.
  • This condition is marked by mineralization defects, reduced osteoid, and fewer osteoclasts and osteoblasts.

Purpose of the Study:

  • To investigate the efficacy of avoiding aluminum-containing phosphate binders (ACPBs) in CAPD patients.
  • To assess the impact of low calcium dialysis fluid and oral calcium carbonate on bone disease management.
  • To evaluate changes in bone histology and serum parathyroid hormone (PTH) levels.

Main Methods:

  • Patients were treated with oral calcium carbonate and "low calcium" (1.25 mMol/l) dialysis fluid, completely avoiding ACPBs.
  • Phosphate levels were monitored, with a target mean below 1.6 mMol/l.
  • Bone biopsies were performed at the start of CAPD and at follow-up in a subset of patients.

Main Results:

  • Phosphate control was good (mean < 1.6 mMol/l), and serum PTH levels decreased significantly over twelve months.
  • Transient, asymptomatic hypercalcemia occurred but did not necessitate ACPB use.
  • Initial bone biopsies in 34 CAPD patients revealed osteitis fibrosa (OF) in over 50%, with 15.6% showing aplastic lesions without aluminum staining. Follow-up biopsies showed mixed responses, with some OF and osteomalacia improving, while aplastic bone sometimes worsened.

Conclusions:

  • Osteitis fibrosa is the predominant bone lesion at the start of CAPD, but a significant proportion (15%) have aplastic bone.
  • "Low calcium" dialysis fluid is effective in enabling the avoidance of ACPBs in most CAPD patients.
  • This approach contributes to managing bone abnormalities in CAPD patients.

Related Experiment Videos