Document Detail

Bone disease in patients with chronic kidney disease under conservative management.
MedLine Citation:
PMID:  15947836     Owner:  NLM     Status:  MEDLINE    
CONTEXT AND OBJECTIVE: Few studies have focused on bone disease in patients with chronic kidney disease under conservative treatment. The objective was to evaluate bone disease in patients with chronic kidney disease. DESIGN AND SETTING: Case series, at the Nephrology Division, Hospital Universitário Pedro Ernesto. METHODS: 131 patients with creatinine clearance from 10 to 60 ml/min/1.73 m(2) were followed up for at least one year. Serum creatinine, albumin, calcium, phosphorus, alkaline phosphatase, total CO2 (tCO2), intact parathyroid hormone (iPTH), and alkaline phosphatase were measured. Creatinine clearance was calculated from 24-hour urine creatinine measurements and protein ingestion estimates from urea assays. RESULTS: Patients presenting creatinine clearance < 30 ml/min/1.73 m(2) had higher iPTH values, but normal serum levels for calcium, phosphorus, alkaline phosphatase and tCO2. Patients presenting iPTH values of twice the normal upper limit (144 pg/ml) showed lower tCO2 values. Bone alkaline phosphatase was evaluated in 37 patients with creatinine clearance < 30 ml/min/1.73 m(2), showing correlation with alkaline phosphatase but not with parathyroid hormone. Bone biopsy on nine patients with creatinine clearance < 30 ml/min/1.73 m(2) and iPTH > 144 pg/ml showed osteitis fibrosa (4), mild lesion (4) and high turnover (1). CONCLUSION: The present data suggest the importance of early control for iPTH and metabolic acidosis, among patients under conservative management for chronic kidney disease, in order to prevent complications related to bone disease.
Carlos Perez Gomes; Maria Inês Barreto Silva; Maria Eugênia Leite Duarte; David Dorigo; Carla Cavalheiro da Silva Lemos; Rachel Bregman
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Publication Detail:
Type:  Journal Article     Date:  2005-06-08
Journal Detail:
Title:  São Paulo medical journal = Revista paulista de medicina     Volume:  123     ISSN:  1516-3180     ISO Abbreviation:  Sao Paulo Med J     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-06-10     Completed Date:  2005-12-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100897261     Medline TA:  Sao Paulo Med J     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  83-7     Citation Subset:  IM    
Nephrology Division, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rua Soares Cabral 71, Laranjeiras Rio de Janeiro, (RJ), Brazil, CEP 22240-070.
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MeSH Terms
Absorptiometry, Photon
Biological Markers / blood
Body Mass Index
Bone Density
Creatinine / blood*
Kidney Failure, Chronic / blood,  complications,  therapy*
Parathyroid Hormone / blood*
Renal Dialysis
Renal Osteodystrophy / etiology*
Reg. No./Substance:
0/Biological Markers; 0/Parathyroid Hormone; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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