Med j club nejm op bs.

Dr.Mohammad Shaikhani. CABM/FRCP

Hyperphosphataemia The Silent Killer Amann K, Gross ML, London GM, Ritz E: Hyperphosphatemia - a silent killer of patients with uremia. NDT , 1999,14,2085-2087 .

Metastatic Calcification & Ossification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Calcium and phosphate are deposited in one of two forms;

CALCIUM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PHOSPHORUS ,[object Object],[object Object],[object Object],[object Object],[object Object]

PHOSPHATE BINDERS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vitamin D (Calcitriol) Start if PTH > 33 pmol/L ( 300 pg/ml) Ca < 2.4 mmol/l ( 6.5 mg/dl) P < 1.8 mmol/l ( 5.5 mg/dl) Ca x P < 4.4 ( 55 mg/dl²) Hold Calcitriol:when PTH < 15 pmol/L(150 pglml) Ca > 2.55 mmol/L (10.2 mg/dl) P > 1.8 mmol/L (1.8 pg/dl)

iPTH ,[object Object],[object Object],[object Object]

When to change the dose of Calcitriol ,[object Object],[object Object]

Characteristics of an Ideal Oral Phosphate Binder ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object]

Med j club nejm op bs.

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