Bone Care Basics (CRF)
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Bone Care Basics (CRF)
- 7. Ca 2+ PO 4 Intestine PO 4 Ca 2+ Kidney D hormone Blood Ca 2+ (& PO 4 ) Bone Osteoclast X Parathyroid Gland
- 8. Vitamin D Receptors (VDR) are Spread Throughout the Body Reproductive Organs Kidneys Intestines Bones Immune System Skin Bone Marrow Pancreas Parathyroid Glands
- 9. Kidney Failure Mortality Rates 2001 USRDS Annual Report
- 10. Kidney Failure Mortality Rates 2001 USRDS Annual Report
- 11. PTH is Directly Related to Mortality Chertow et al, ASN Renal Week Abstracts
- 16. When SHPT Begins Martinez I, Saracho R, Montenegro J, Llach F: A deficit of calcitriol synthesis may not be the initial factor in the pathogenesis of secondary hyperparathyroidism. Nephrol Dial Transplant 11 Suppl 3:22-28, 1996.
- 23. EBCT Scans Reveal Coronary Artery Calcification in a Dialysis Patient Yellow indicates calcium deposition Slide courtesy of P. Raggi. Bone
- 24. Mitral Valve Calcification in a Dialysis Patient Scan courtesy of P. Raggi.
- 25. Calcification of the Lung Sanders C, et al. Am J Roentgenol. 1987;149:881-887. Kuzela DC, et al. Am J Pathol. 1977;86:403-424. Slide courtesy of E. Slatopolsky. Calcified Noncalcified
- 26. Cutaneous/Subcutaneous Calcification Slide courtesy of H. Malluche.
- 31. Bone Bone-lining cells Osteoblasts Osteoclasts Osteocytes
- 32. Bone
- 40. Development of Renal Bone Disease Core Curriculum for Nephrology Nurses , 1998 GFR D hormone metabolism Plasma HPO 4 Ca ++ absorption from GI tract Plasma Ca ++ PTH osteoclasts Ca ++ & HPO 4 – resorbed from bones OSTEODYSTROPHIES CaHPO 4 product METASTATIC CALCIFICATIONS
- 46. Percentage of New Chronic Dialysis Patients Treated with D Hormone Therapy* *2001 USRDS Annual Report Treated with D hormone Hemodialysis Patients Peritoneal Dialysis Patients
- 48. Treatment Option for SHPT IV Vitamin D Hormone Therapy* *No Clinical Significance NO NO NO Removed by HD? High High High Protein Binding Hepatic Hepatic Hepatic Elimination 5 minutes 5 minutes 8-9 hours Time to max conc. 19±3 16±9 32-37 Half-Life (hr) Calcijex ® calcitriol Zemplar ® paricalcitol Hectorol ® doxercalciferol
Notes de l'éditeur
- Welcome to this Continuing Education Program. Thank you for taking the time to participate in this program on Bone Care Basics. The management of bone disease in the chronic renal failure population is an important goal for renal professionals. It is important to realize that you have the power to effect the lives of your patients by aiding in the management, and hopefully, by eventually preventing the devastating effects of Bone Disease. With the publication of the KDOQI Bone and Mineral Metabolism Guidelines there are standards for the management of SHPT. The purpose of this course is to provide basic information on secondary hyperparathyroidism and renal bone disease.