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

Does strict phosphorus control precipitate renal osteomalacia?

J A Delmez, M D Fallon, H R Harter

    The Journal of Clinical Endocrinology and Metabolism
    |April 1, 1986
    PubMed
    Summary

    Strict phosphorus control in hemodialysis patients prevents hyperparathyroid bone disease but can lead to aluminum-associated osteomalacia. This highlights a trade-off in managing bone complications in chronic kidney disease.

    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

    Physiological condition differentially affects the behavior and survival of two populations of sockeye salmon during their freshwater spawning migration.

    Physiological and biochemical zoology : PBZ·2010
    Same author

    Differential effects of vitamin D receptor activators on vascular calcification in uremic rats.

    Kidney international·2007
    Same author

    MicroRNA-223 is a key factor in osteoclast differentiation.

    Journal of cellular biochemistry·2007
    Same author

    Function and effect of bone morphogenetic protein-7 in kidney bone and the bone-vascular links in chronic kidney disease.

    European journal of clinical investigation·2006
    Same author

    Pathogenic mechanisms for parathyroid hyperplasia.

    Kidney international. Supplement·2006
    Same author

    25-Hydroxyvitamin D(3) suppresses PTH synthesis and secretion by bovine parathyroid cells.

    Kidney international·2006

    Area of Science:

    • Nephrology
    • Bone Histology
    • Mineral Metabolism

    Background:

    • Hyperphosphatemia is linked to osteitis fibrosa in chronic renal failure.
    • Hypophosphatemia or aluminum intoxication can cause osteomalacia in uremic patients.
    • Aluminum-containing phosphate binders may worsen osteomalacia while treating hyperparathyroidism.

    Purpose of the Study:

    • To evaluate the impact of strict phosphorus control using aluminum-containing gels on bone histology in hemodialysis patients.
    • To compare bone histologies between patients with strict phosphorus control and those with random phosphorus levels.

    Main Methods:

    • Bone biopsies were analyzed from 10 hemodialysis patients with strict phosphorus control (4-5 mg/dl) and 46 randomly selected patients.
    • Circulating immunoreactive parathyroid hormone (PTH) and alkaline phosphatase levels were measured.

    Related Experiment Videos

  • Bone aluminum accumulation and osteoid accumulation were assessed histologically.

    • Main Results:

    • The strict-phosphorus group showed lower PTH and alkaline phosphatase levels, indicating less hyperparathyroid bone disease.
    • The strict-phosphorus group exhibited moderate osteoid accumulation and reduced tetracycline labeling, consistent with osteomalacia.
    • All patients in the strict-phosphorus group had evidence of bone aluminum accumulation.

    Conclusions:

    • Maintaining normal serum phosphorus levels with aluminum-containing gels effectively prevents severe hyperparathyroid bone disease in hemodialysis patients.
    • This management strategy is associated with a moderate degree of aluminum-associated osteomalacia.
    • Careful consideration of the risks and benefits of aluminum-containing phosphate binders is crucial in managing renal bone disease.