Effect of CAPD on Renal Osteodystrophy in Unmodified Patients Moving from Hemodialysis to CAPD
The effect of one year of CAPD on bone histology was studied in seven hemodialysis patients changing to CAPD. The course of these patients was not modified by oral calcium supplements, vitamin D or parathyroid ablation. An existing pattern of dialysis osteomalacia in three patients changed in two to osteitis fibrosa. This change was associated with decreased stainable aluminum in the bone biopsies obtained during CAPD. The specific role played by CAPD in effecting this change is uncertain. Progression and development of osteitis fibrosa in these patients was not prevented by a 7.0 mg/dl calcium containing dialysis solution. The observed persistence of abnormally high parathyroid hormone levels and increasing alkaline phosphatase concentrations supports the concept that a negative calcium balance may be a critical factor in progression of osteitis fibrosa among CAPD patients.
KeywordsRenal Osteodystrophy Osteitis Fibrosa Negative Calcium Balance Oral Calcium Supplement Serum Phosphorus Concentration
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