Bones

[dkerr]

In the past two years, I've broken my left arm in two different places and both wrists.  I would fall, break bones, and within 48 hours be admitted to the hospital with sepsis every time.  It was crazy. My goalis to stay upright and not break any more bones.  Its like I'm made out of glass.  Very frustrating.  My husband likes to ride his bike and would love me to go with, but I'm too scared of falling.  Anyone else had similar problems with their bones?

[okarol]

This is from: http://www.renalweb.com/topics/out_bonedisease/bonedisease.htm

Bone Disease Prevention and Management
Unless closely monitored, renal bone disease (renal osteodystrophy) is a problem that will be experienced by most people suffering from end stage renal disease (ESRD). Renal bone disease is a complex issue and involves many more factors than can be listed in this limited space. Only the very basics are outlined here.

First, the kidneys are involved in the synthesis of vitamin D, which is the most essential factor regulating intestinal absorption of calcium in humans. When the kidneys fail and less vitamin D is created, the amount of calcium absorbed by the intestines is reduced. Calcium is most essential substance for bone maintenance and health. Next, calcium and phosphorus levels in the blood (which are normally regulated by the kidneys) are dependent upon each other. Therefore, when the kidneys fail and the phosphorus level in the blood goes up, the (free) calcium level in the blood decreases. In response to these two factors that lower serum calcium, the body then increases the parathyroid hormone (PTH) level in the blood.  PTH causes calcium to be released from the bones in order to increase the serum calcium level.  Left untreated, an ESRD patient will have bones that are depleted of calcium, brittle, and likely to fracture.

Treatment and prevention of renal bone disease usually include the use of phosphate binders and vitamin D analogs (to reduce PTH levels).  In the past, treatment frequently included the removal of the parathyroid glands.

Normal serum calcium is 8.5-10.8 mg/dL.

Normal serum phosphorus for dialysis patients is 3.5 to 5.5 mg/dl High phosphorus levels also cause itchy skin.

It is recommended that ESRD patients maintain a calcium phosphorous product that is below 70.

Check out that site - there are many more articles and related resources.

[Chris]

I didn't break any bones the way you did, but after having some pain in my back and knee, I had test done. They showed I have osteomalacia and if it wasn't taken care of soon, it would become osteoporosis. The doctors to me that this was due to a combination of things though. It was explained to me as the cause is from having diabetes, being on dialysis, transplant medications and diet.

I would talk to your doctor about it to see a doctor who specializes in bone health and have a bone density scan along with some blood draws. You could possibly be suffering from osteomalacia or osteoprosis and need some meds to help.
Good Luck

[Sluff]

Not much too add after Karols post, but our creator Epoman was confined to a wheelchair due to this problem.

[kevno]

Bones.

3 times now the doctors have threatened me with a wheelchair. Once when I fell and broke both my knee, three months zimmer frame, one year on two elbow crunches, two years with a stick. Plus 3 years 2 times a week in the hydro pool, Once when they found out how thin the bones in my hip were. The Surgeons talking about plating both hips. But it was found out my parathyroid glands where overactive. So had 3 and three quarters removed. Now the bone on hips as grown back. These took place 90 - 91. Then the 3rd time to amputate my right leg.  But said NO and still saying NO two years later. Just now my bones ache all the time. Walking but finding it is getting harder. But you just have to keep going. Pain after a while you get use to. You have no choice being a long term renal patient. How ever careful you are with the food you eat and the fluid you drink, plus tabels you take. It catches up with you in the end.

 

[Meinuk]

There is a free webinar on Renal Bone Disease Next Week (it will also be available as an archive after the original date for future viewing). 

Here is a cross post:

Webinar: Renal Bone Disease, Tuesday August 26, 2008

Presented by: Medical Education Institute Tuesday , August 26, at 8:50pm EDT

MEI (homedialysis.org) is presenting a free, live interactive seminar on the web. (webinar) Webinars work well, because there is a level of communication that reaches deeper than just reading on the web.  You can sit, watch and listen and it is also interactive during the Q&A portion, so you can type questions for the speaker. Sometimes, being on dialysis can be isolating - joining in on a webinar is a way to interact and learn.

This month, Dr. Stuart Sprague, from Northwestern University, will be talking about renal bone disease.  Bone disease is a crippling co-morbidity to CKD, and can often be kept in check with early detection, drug therapy and dietary adjustment.  I'll be checking on to see what Dr. Sprague has to say.

Since you are already on the net (after all, you are reading this) why not register at wiziq (for free) and join in on Tuesday night.

The session will be held at:
1:50am (Wednesday) GMT/London
6:00pm (Tuesday) US Pacific time
7:00pm (Tuesday)US Mountain time
8:00pm (Tuesday)US Central time
9:00pm (Tuesday)US Eastern time
11:00am (THURSDAY) Australia (Geelong) time
6:20am (Thursday) Mumbai, India

goto http://www.wiziq.com/TutorSession/Session.aspx?JuX%2bgH%2b2GbZWOlqsbSK5GOnxEyZzw%2bcWYGDgkAzuzNZBKJOKdrr7hxJRDCz4W06JGPCMLmmPS70%3dto sign up.

1. If you are new to the WiZiQ site, click "Not a member? Register." Fill in your name, email address, and choose a password, and click "Join Now." When the session time rolls around, click "LAUNCH" and you're in!

2. If you have signed up for WiZiQ, Log in. When the session time rolls around, click "LAUNCH" and you're in! (NOTE: WiZiQ has upgraded its site security so you may need a new password).

*To sign up for a PRIZE drawing and get an email reminder before the session, please send an email with "WEBINAR" in the subject heading to: info@homedialysis.org. Win a pair of headphones donated by Genesis Worldwide Enterprises! Or, nutrition supplements from VitalRemedyMD, Anasept antiseptic from Smith Biomedical, Topicaine ointment, from ESBA labs, or Bleach wipes or ExSept Plus skin antiseptic from Alcavis. All prizes were donated by companies with listings in HDC's Helpful Products Catalog.

[Zach]

Normal serum calcium is 8.5-10.8 mg/dL.

It is recommended that ESRD patients maintain a calcium phosphorous product that is below 70.[/i]

Some of those numbers are out-of-date:

According to the National Kidney Foundation (U.S.A.) KDOQI Guidelines:

Serum concentrations of corrected total calcium should be maintained within the normal range for the laboratory used, preferably toward the lower end (8.4-9.5 mg/dl [2.10-2.37 mmol/L]).

The serum calcium-phosphorus product (Ca X PO4) should be maintained at less than 55 mg2/dl2.

[okarol]

Normal serum calcium is 8.5-10.8 mg/dL.

It is recommended that ESRD patients maintain a calcium phosphorous product that is below 70.[/i]

Some of those numbers are out-of-date:

According to the National Kidney Foundation (U.S.A.) KDOQI Guidelines:

Serum concentrations of corrected total calcium should be maintained within the normal range for the laboratory used, preferably toward the lower end (8.4-9.5 mg/dl [2.10-2.37 mmol/L]).

The serum calcium-phosphorus product (Ca X PO4) should be maintained at less than 55 mg2/dl2.

Thanks Zack - the info I listed said "Last Updated 07/13/08" so I figured it was current. I appreciate the correction.