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Title: What can be given to patient of chronic renal failure on hemodialysis when serum phosphorus too high serum PTH? Post by: smn on Dec 12, 2012 To nephrologist what medication can be given to patient of chronic renal failure on hemodialysis when serum phosphorus too high as well as serum PTH
Title: What can be given to patient of chronic renal failure on hemodialysis when serum phosphorus too high serum PTH? Post by: ilohim on Dec 12, 2012 1) Phos-Lo
2) Zemplar Title: What can be given to patient of chronic renal failure on hemodialysis when serum phosphorus too high serum PTH? Post by: smnam on Dec 12, 2012 As well as the medications the others have suggested, the most important thing to give is vitamin D. Healthy kidneys convert inactive 25-hydroxyvitamin D into the active form - 1, 25-hydroxy vitamin D (aka calcitriol), with an enzyme called 1-alpha hydroxylase. In chronic renal failure, the kidneys aren't able to activate enough vitamin D. Vit D is crucial for stimulating absorption of calcium from the gut and stimulating retention of calcium in the kidneys. So too little active Vit D leads to calcium deficiency.
Low calcium leads to release of PTH (parathyroid hormone) from the parathyroid glands. PTH releases calcium from the bones, to try and maintain the blood calcium level. It also releases lots of phosphate from the bones. In a healthy person, the high PTH would stimulate excretion of all the excess phosphate in the urine, but in someone with kidney failure, this doesn't happen, so it builds up. High phosphate stimulates more PTH release and it's a vicious circle. The first and most important treatment option is to give 1,25-vitamin D (calcitriol). |