Peritoneal Dialysis International, Vol 21, Issue Suppl_3, S241-S246
Copyright © 2001 by International Society for Peritoneal Dialysis
Current issues in the management of secondary hyperparathyroidism and bone disease
SM Moe
Wishard Memorial Hospital, Indiana University School of Medicine, Indianapolis 46202, USA. smoe@iupui.edu
Recent research has demonstrated active bone-like remodelling of vascular tissue in dialysis and non dialysis patients. Cross-sectional studies indicate that the presence of vascular calcification is inversely related to bone mass. Theoretically, the relationship implies that maintaining normal bone turnover and mass may help to decrease vascular calcification. In addition, it is now apparent that phosphorus and the Ca x P product need to be kept as close to normal as possible. Thus, the present goal should be a serum phosphorus of 3.5-5.5 mg/dL, a Ca x P product of <55 mg/dL, and a PTH of around 150-200 pg/mL with the intact assay. Ten years ago, those goals would have been impossible. However, new pharmacologic agents will make their achievement much more realistic.
