What are characteristics of Adynamic bone disease?
What are characteristics of Adynamic bone disease?
Adynamic bone disease (ABD) is a variety of renal osteodystrophy characterized by reduced osteblasts and osteoclasts, no accumulation of osteoid and markedly low bone turnover.
How is Adynamic bone disease treated?
Adynamic bone is treated by increasing bone turnover through an increase in PTH. This can best be accomplished by lowering doses of calcium-based phosphate binders and vitamin D or entirely eliminating such therapy. The lowering of dialysate calcium (1.0 to 2.0 mEq/L) has also been suggested as a possible approach.
What is secondary hyperparathyroidism?
Secondary hyperparathyroidism occurs when the parathyroid glands become enlarged and release too much PTH, causing a high blood level of PTH. There are several reasons why this happens in patients with kidney disease: Higher blood phosphorus levels. The kidneys cannot make active vitamin D (needed to absorb calcium)
What is osteodystrophy?
Osteodystrophy (ie, renal rickets) is the only type of rickets with a high serum phosphate level. It can be adynamic (a reduction in osteoblastic activity) or hyperdynamic (increased bone turnover).
What causes Adynamic bone disease?
The pathogenesis of adynamic bone disease is not well defined, but possible contributing factors include the following: High calcium load. Use of vitamin D sterols. Increasing age.
How is Adynamic bone disease diagnosed?
Adynamic bone disease is characterized by a low-bone-turnover state. Bone biopsy remains the diagnostic gold standard for adynamic bone disease. Aggressive PTH suppression can increase the risk of this disease process.
Does secondary hyperparathyroidism need surgery?
For patients with secondary hyperparathyroidism from kidney failure, the only treatment is to have a kidney transplant. If the underlying problem cannot be fixed, the best treatment is medical therapy and surgery is only done for patients in whom optimal medical therapy is not working.
Why do kidney patients often have bone disease?
When kidneys do not function properly, extra parathyroid hormone is released in the blood to move calcium from inside the bones into the blood. Chronic kidney disease causes mineral and bone disorder because the kidneys do not properly balance the mineral levels in the body.
What is hungry bone disease?
Hungry bone syndrome (HBS) refers to the rapid, profound, and prolonged hypocalcaemia associated with hypophosphataemia and hypomagnesaemia, and is exacerbated by suppressed parathyroid hormone (PTH) levels, which follows parathyroidectomy in patients with severe primary hyperparathyroidism (PHPT) and preoperative high …
What does parathyroid hormone do to bone?
PTH raises calcium levels by releasing calcium from your bones and increasing the amount of calcium absorbed from your small intestine. When blood-calcium levels are too high, the parathyroid glands produce less PTH .