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Renal Osteodystrophy Review Articles

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Renal osteodystrophy is currently defined as an alteration of bone morphology in patients with chronic kidney disease (CKD). It is one measure of the skeletal component of the systemic disorder of chronic kidney disease-mineral and bone disorder (CKD-MBD). Typical symptoms can be: Bone pain, Joint pain ,Bone deformation, Bone fractures, Poor mobility. Testing for renal osteodystrophy involves taking a blood sample to measure your levels of calcium, phosphorus and PTH. If you are on dialysis, calcium and phosphorus tests are done on a monthly basis (or sometimes more frequently). PTH is measured quarterly for most patients—although testing may be done more frequently for people just starting vitamin D therapy or those with severe bone disease while the healthcare team is determining the correct dosage of vitamin D. Your renal dietitian will review your lab results and recommend changes in your diet or change your phosphorus binder prescription. The goal of treating renal osteodystrophy is to restore balance between calcium, PTH, phosphorus and vitamin D in the body. Renal osteodystrophy can be managed with phosphorus binders, activated vitamin D and a low-phosphorus diet. If you have a high level of PTH in your blood, it’s important to bring it back to a normal level to prevent calcium loss from your bones. Medicines to treat renal osteodystrophy can be given in pill form, but are usually given intravenously during dialysis treatments for people on in-center hemodialysis. These medicines are only used in people with kidney disease. Another drug that may be used acts directly on the parathyroid glands to block PTH release. In severe cases the parathyroid glands may be surgically removed. Review articles in academic journals analyze or discuss research previously published by others, rather than reporting new experimental results.[2][3] An expert's opinion is valuable, but an expert's assessment of the literature can be more valuable. When reading individual articles, readers could miss features that are apparent to an expert clinician-researcher. Readers benefit from the expert's explanation and assessment of the validity and applicability of individual studies 

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