Hyperphosphataemia occurs in nearly all patients with end-stage renal disease (ESRD). In the past, the need to manage hyperphosphataemia focused primarily on its role as a contributor to secondary hyperparathyroidism and renal osteodystrophy. There is now widespread recognition that disturbances in phosphorus metabolism and/or the therapeutic measures used to manage it are important risk factor...

_______________________________ Correspondence to: Goce B Spasovski, MD, PhD, Department of Nephrology, Clinical Center Skopje, Vodnjanska 17, 1000 Skopje, Macedonia, Fax: +389 2 3220 935 or +389 2 3231 501, E-mail: [email protected] Comparative Effects of Lanthanum Carbonate and Calcium Carbonate on Renal Osteodystrophy in Patients with End-Stage Renal Disease G.B. Spasovski , A. Sikole, S. G...

As renal function declines, the accumulation of phosphate adversely affects mineral homeostasis and bone turnover. The consequences of this imbalance include secondary hyperparathyroidism (2oHPT), osteodystrophy, and vascular calcification. High phosphate levels are a key factor in the pathogenesis of 2oHPT. Hyperphosphatemia is common in uraemic patients due to a reduced excretion of phosphate...

Brown tumors are relatively uncommon but they are serious complications of renal osteodystrophy. We describe a 31-year-old woman with end-stage renal disease who had undergone hemodialysis for nine years and developed severe secondary hyperparathyroidism and a maxilla brown tumor despite increasing doses of oral calcitriol and calcium carbonate. The fast increase of the right maxillary bone tum...

This review considers many new basic and clinical aspects of parathyroid hormone (PTH). We focus especially on the identification of PTH fragments and how they may relate to renal failure, diagnosis, and treatment of secondary hyperparathyroidism and renal osteodystrophy. The biosynthesis and metabolism of PTH, measurement of circulating forms of PTH, the effects of PTH on receptor activation a...

Vascular calcification (VC) is an important complication of chronic renal failure (CRF), and a risk factor for reduced survival. Osteoblast-like cells in the vessel wall derived from resident vascular smooth muscle cells (VSMC) are considered central to the pathogenesis of VC, which is exacerbated by mineral ion abnormalities inherent in renal osteodystrophy (ROD). Nevertheless, its aetiology i...

Vascular calcification (VC) occurs frequently in chronic kidney disease, contributing to cardiovascular mortality. Numerous risk factors have been identified, including renal osteodystrophy and bone turnover, with low turnover as a main determinant. Other reports support high turnover as a factor in VC. Calcimimetics, which lower serum parathyroid hormone, and parathyroidectomy each prevented V...

It has long been recognized that chronic renal failure (CRF) in children is associated with growth delay. Still In our days nevertheless, growth retardation remains today a major impediment to the full rehabilitation of children with CRF. The reduction of in height velocity frequently results in diminished final adult height. Available evidence suggests that growth retardation might be the resu...