Secondary hyperparathyroidism remains the most frequent type of renal osteodystrophy today. Treatment has been based on the better knowledge of pathogenesis in the last few years. Preventive measures must be taken in early renal failure by the maintenance of normal serum calcium and phosphorous levels, in addition to calcitriol supplementation. Besides diet, oral phosphate binders, mainly calcium carbonate are used in the treatment of hyperphosphataemia. Aluminium containing drugs should be only in exceptional cases. Removal of phosphorous can be enhanced by more effective dialysis. The calcium content of the dialysate should be decreased to prevent the hypercalcaemia caused by administered calcium carbonate and calcitriol. Developed hyperparathyroidism must be treated by intermittent higher calcitriol doses. Control of serum intact parathormone level is useful also in the prevention of overcorrection of hyperparathyroidism during calcitriol treatment. In case of significant parathyroid hyperplasia parathyroidectomy should be performed in time.
|Number of pages||8|
|Publication status||Published - Dec 1 1995|
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