Management of musculoskeletal complications in endstage renal disease: an update.

Abstract

People treated with prolonged hemodialysis now survive longer and increasingly develop musculoskeletal complications. Significant advances have been made in the management of musculoskeletal manifestations in patients undergoing hemodialysis for endstage renal disease. Noncalcium-based phosphate binders are preferred for the management of hyperphosphatemia. Vitamin D therapy is based on intact parathyroid hormone levels. Newer Vitamin D sterols and calcimimetic agents seem to control secondary hyperparathyroidism without increasing the calcium-phosphorous product. Use of biocompatible dialyzers for hemodialysis may delay articular manifestations of beta-2 microglobulin amyloidosis. Beta-2 microglobulin adsorption columns when used along with hemodialysis may lead to lower beta-2 microglobulin levels and improvement in articular manifestations of beta-2 microglobulin amyloidosis. In this review, we focus on the latest advancements in the management of secondary hyperparathyroidism and beta-2 microglobulin amyloidosis.

• Authors: Dharmarajan Ramaswamy, Petros Efthimiou, Isaiarasi Gnanasekharan, Anita Soni
• Journal: Clinical rheumatology (Clin Rheumatol) Vol. 25 Issue 4 Pg. 440-2 (Jul 2006) ISSN: 0770-3198 [Print] Germany
• PMID: 16267605 (Publication Type: Journal Article, Review)

Chemical References

• beta 2-Microglobulin

Topics

• Amyloidosis (blood, complications, therapy)
• Humans
• Hyperparathyroidism, Secondary (complications, prevention & control, therapy)
• Kidney Failure, Chronic (blood, complications, therapy)
• Musculoskeletal Diseases (complications, therapy)
• beta 2-Microglobulin (blood)