Effect of Dialysis Modality on Bone Disease in patient with End Stage Renal Disease

Abstract Background The kidney plays a vital role in the metabolism of minerals and bone health. It is not only the target organ of several regulating hormones such as parathormon (PTH) and fibroblast growth factor-23 (FGF-23), but it is also the main organ that activates vitamin D. Calcium and phosphorus are fundamentally important in a wide array of biological functions. Abnormalities in calcium, phosphorus, parathyroid hormone (PTH), and vitamin D metabolism (usually referred to as disordered mineral metabolism) are common in patients with (CKD). Aim of the work Comparing the effect of hemodiafiltration (HDF) versus conventional Hemodialysis on bone markers. Patients and Methods The study was performed on 50 patients in Ain Shams University Specialized Hospital with end-stage renal failure treated by means of chronic hemodialysis (n = 25) and hemodiafiltration (n = 25). Inclusion criteria were end stage renal disease patients on regular hemodialysis for > 6 months, their age> 18 years old, no recent infection (normal CRP), cardiac or vascular access complication, none of the patients had history of bone disease, fracture or malignancy. As regarding blood transfusion and drug intake (affect bone metabolism or hemostasis) had not administered for 1 month perior to study. Results Both groups had lower levels of serum creatinine before and after sessions of HD or HDF but Hemodialysis (HD) patients has higher levels of phosphate and bone ALP, than patients on HDF. Conclusion Hemodiafiltration (HDF) has better effect on bone metabolism than Hemodialysis (HD).

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Secondary Hyperparathyroidism in End-Stage Renal Disease: No Longer a Matter for Surgeons?

Blood Purification ◽

10.1159/000445204 ◽

2016 ◽

Vol 42 (1) ◽

pp. 44-48 ◽

Cited By ~ 3

Author(s):

Mario Cozzolino ◽

Francesca Elli ◽

Stefano Carugo ◽

Paola Ciceri

Keyword(s):

Vitamin D ◽

Renal Disease ◽

Secondary Hyperparathyroidism ◽

End Stage Renal Disease ◽

Fibroblast Growth Factor 23 ◽

Phosphate Binders ◽

High Turnover ◽

Skeletal Resistance ◽

Stage Renal Disease ◽

End Stage

Hyperphosphatemia, hypocalcemia and vitamin D deficiency are the main factors involved in the pathogenesis of secondary hyperparathyroidism (SHPT). Moreover, the skeletal resistance to parathyroid hormone is not only a high-turnover bone accompanying SHPT, but may also play a crucial role in the onset of low-turnover bone disease in uremia. However, a growing body of evidence suggests that other hormones play a key role in this disease, such as fibroblast growth factor 23, Klotho and sclerostin. SHPT causes both bone-associated and non-skeletal consequences, including cardiovascular calcifications. Furthermore, vitamin D and calcium (Ca)-containing phosphate binders may increase Ca load. Anyway, the rate of parathyroidectomy in end-stage renal disease has greatly decreased during the last decade. Is there any room left for surgeons?

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Fibroblast growth factor-23 correlates with advanced disease conditions and predicts high risk of major adverse cardiac and cerebral events in end-stage renal disease patients undergoing continuous ambulatory peritoneal dialysis

Journal of Nephrology ◽

10.1007/s40620-018-0557-4 ◽

2018 ◽

Vol 32 (2) ◽

pp. 307-314 ◽

Cited By ~ 2

Author(s):

Li Xu ◽

Xiaosong Hu ◽

Wenli Chen

Keyword(s):

Peritoneal Dialysis ◽

Growth Factor ◽

High Risk ◽

Renal Disease ◽

End Stage Renal Disease ◽

Advanced Disease ◽

Fibroblast Growth Factor 23 ◽

Fibroblast Growth ◽

Stage Renal Disease ◽

End Stage

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Role of vitamin D in oxidative stress modulation in end‐stage renal disease patients: A double‐blind randomized clinical trial

Hemodialysis International ◽

10.1111/hdi.12849 ◽

2020 ◽

Vol 24 (3) ◽

pp. 367-373

Author(s):

Leila Malekmakan ◽

Zeinab Karimi ◽

Afshin Mansourian ◽

Maryam Pakfetrat ◽

Jamshid Roozbeh ◽

...

Keyword(s):

Oxidative Stress ◽

Clinical Trial ◽

Vitamin D ◽

Renal Disease ◽

Randomized Clinical Trial ◽

End Stage Renal Disease ◽

Double Blind ◽

Stage Renal Disease ◽

End Stage

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Peritoneal dialysis

10.1093/med/9780199592548.003.0265 ◽

2015 ◽

Author(s):

Anjali Bhatt Saxena

Keyword(s):

Peritoneal Dialysis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Mineral Metabolism ◽

Pressure Control ◽

Dialysis Adequacy ◽

Waste Products ◽

Stage Renal Disease ◽

End Stage ◽

Small Solute

Dialysis adequacy is a term used to describe how well any dialysis therapy effectively mitigates some of the uraemic complications of end-stage renal disease. In the simplest terms, dialysis adequacy measures the dose of dialysis and judges it to be sufficient (adequate) or insufficient (inadequate). In peritoneal dialysis, adequacy refers to the ability of dialysis to perform any or all of myriad tasks including (a) removing metabolic waste products, (b) maintaining proper fluid balance and blood pressure control, (c) removing excess electrolytes, (d) correcting acid–base imbalances, (e) maintaining healthy bone mineral metabolism, and (f) promoting the maintenance of a proper nutritional status. In practice, peritoneal dialysis adequacy is most often measured mono-dimensionally, in terms of small solute (i.e. urea) clearances; however, it is most useful to incorporate a wider view of dialysis adequacy when caring for patients with end-stage renal disease.

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