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[Osteopenia. A problem of long-term dialysis]
Fortschritte Der Medizin
|February 11, 1982
Summary
Hemodialysis-induced osteopenia, a complication in 5-10% of patients, can often be prevented by adjusting dialysate composition. Effective treatment requires precise bone classification and monitoring of parathormone and fluoride levels.
Area of Science:
- Nephrology
- Bone Metabolism
- Mineral and Electrolyte Disorders
Context:
- Long-term hemodialysis is associated with serious late complications, including osteopenia.
- Osteopenia affects 5-10% of patients undergoing hemodialysis.
- Conventional dialysate electrolyte composition may contribute to osteopenia development.
Purpose:
- To discuss the prevention and treatment of hemodialysis-induced osteopenia.
- To highlight the importance of precise histological bone classification and biochemical markers for treatment.
- To outline therapeutic strategies and monitoring protocols for managing this condition.
Summary:
- Adjusting dialysate electrolyte composition can prevent osteopenia in many hemodialysis patients.
- Accurate histological bone evaluation and measurement of parathormone and fluoride levels are crucial preconditions for effective treatment.
- Therapy involves decreasing dialysate calcium and magnesium, increasing sodium fluoride (NaF), and administering 1,25(OH)2D3, with careful monitoring of calcium, phosphate, and fluoride metabolism.
Impact:
- Provides insights into managing a significant complication of chronic kidney disease treatment.
- Emphasizes a proactive approach to bone health in hemodialysis patients.
- Offers a framework for optimizing therapeutic interventions and patient surveillance to mitigate bone disease.