Complication of renal osteodystrophy

As a long-term complication of renal osteodystrophy in uremic hemodialysis patients have serious impact on the quality of life of many patients early in the illness, they even are absolutely ignorant of, yet it is hidden in our biggest worry about long-term dialysis affects the quality of life, had caused the attention of hemodialysis patients with uremia; severe renal osteodystrophy can cause a decrease in bone density bone, calcification, osteoporosis, bone fragility, easily lead to fractures, bone deformation, proximal muscle weakness appeared severe muscle atrophy leads to difficulty in walking; I and many years of maintenance dialysis treatment with bone disease sufferers is one example, many also in dialysis patients often ask me how to prevent the experience of treatment experience of all relevant information and their sorting out hope that we have a deeper on renal osteodystrophy, the better to keep a long period through prevention Analysis of stable and secure quality of life; progress of renal osteodystrophy is very slow, but in early stage of renal failure, it is caused by the complication of complication, the bone disease becomes more and more serious;

1, the earlier common aluminum poisoning using phosphate binders containing phosphorus reduction can be saved is high aluminum content in the dialysate caused the patient blood aluminum aluminum is too high, too high will hinder the bone formation and bone mineralization, resulting in dialysis of rickets, parathyroid hormone (PTH) is relatively low; with the development of Medicine is generally relatively rare not much to say;

2, metabolic acidosis in the blood pH generally in the early stage of chronic renal failure will increase the phenomenon, so after renal failure associated with metabolic acidosis, a common complication of the disease, long-term acid is too high will make the skeletal compensatory function, stimulate excessive secretion of parathyroid PTH, leading to impaired bone mineralization, osteoporosis; treatment: reduce the intake of acidic foods, with Sodium Bicarbonate Tablets to correct;

3, abnormal calcium phosphorus metabolism PTH rose this is the most important point, because of kidney damage, the body needs to reduce VD3 secretion, regulating electrolyte disorders, the formation of calcium low phosphorus high abnormal renal failure early, if not adjusted, long-term high calcium and phosphorus will lead to parathyroid hormone (PTH) rising eventually lead to more severe renal osteodystrophy; treatment: high phosphorus, high phosphorus foods, limit below 800 milligrams per day; phosphorus application of calcium carbonate or calcium acetate dialysis or hemofiltration; high perfusion, can remove the high phosphorus and hemodialysis must not be able to clear the toxins. The product of calcium and phosphorus (calcium phosphate conversion; for example: 2.2 times 4 is 8.5 mg of calcium and phosphorus. 2 times 3 is 6 mg.8.5 by 6 is equal to 51, the calcium phosphorus product 51) this formula is very important to remember all the best, no more than 50 of the fixed supply situation Ossification of three alcohols to promote calcium absorption; taking ossification of three alcohols; also monitoring electrolytes;

4, secondary hyperparathyroidism parathyroid hormone (PTH) hyperthyroidism makes renal osteodystrophy further increase, rising PTH is because of the long-term calcium and phosphorus disorders do not get timely treatment result, high to a certain extent is very troublesome, so we must pay much attention, timely adjustment of calcium and phosphorus is not high the use of ossification in three alcohol prevention; PTH has high up mates, in premise of the calcium phosphorus product does not exceed 50, the impact of treatment with ossification in three alcohol, the usual dose of 2-4 micrograms, such as Luo Gaiquan and one micro 0.25 micrograms a week the impact of the amount of up to 16 particles, or even higher; at present the existing injection doxercalciferol we can effect better than oral; during the period of shock must detect the electrolyte, prevent calcium; part of hypercalcemic patients can try to use the salmon calcitonin to calcium in the blood metastasis to the bone to increase bone Density, there are patients tried, I personally feel good, but not yet used, we have the situation of excessive calcium can ask the doctor to see; the whole process of shock, the best experienced doctor to help adjust;

In addition PTH is too high, the parathyroid nodules, can contact a doctor can do parathyroidectomy and parathyroid a total of four about soybean, distributed in the thyroid after next is small operation but this surgical technique is very strong, with enough PTH not fall down, all was not the most common so everyone if you want to find some of this surgery are more familiar with the operation of doctors;

Other long term hemodialysis with heparin for anticoagulation, relevant information says long-term large doses of heparin can lead to osteoporosis, estrogen deficiency will cause the imbalance of bone remodeling, more common in women may be associated with this disease causes; dietary protein deficiency limits the intake of the body Vc and B6, the two are required for synthesis of bone collagen although the long-term renal osteodystrophy. The quality of life of patients with uremia difficult to avoid complications but it is completely preventable, particularly with the quality of life in our society now more and more high, the medical reform also increased, our dialysis patients dialysis quality has greatly improved, believe that as long as the good adjustment prevention is can avoid aggravating.

The above is written for some of his own experience the experience of treatment of renal osteodystrophy, we rely on long-term maintenance dialysis is too important, each patients can not escape, so up to everyone to share if there is wrong. Welcome to communicate with you; for this disease I have done two times parathyroidectomy to PTH (parathyroid hormone) down, at present all indicators may be restored, bone also slowly improved, there have been more than a year.

 

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