Dietary and pharmacotherapeutic considerations in the management of renal osteodystrophy

Renal osteodystrophy is an early complication of renal failure associated with significant morbidity. An understanding of dietary management and pharmacotherapeutic prevention and treatment of this condition is essential for members of the nephrology interdisciplinary team. The purpose of this article is to summarize the practical considerations of dietary and pharmacological management in renal osteodystrophy. Experientially based information from a 300-patient dialysis center is provided within specific guidelines, including sample diets and a pharmacotherapeutic algorithm. Treatment-outcome goals for serum phosphorus, serum calcium, and parathyroid hormone are discussed. Patient-specific factors are also discussed, including phosphorus load, calcium load, vitamin D supplementation, and dialysis treatment parameters.