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Topics:
Internal Medicine • Nephrology • Endocrinology • End stage kidney disease • Bone and Calcium Disorders
Is there a role for calcitriol in dialysis patients regardless of PTH level?
Calcitriol has important non-bone effects and dialysis patients can’t make it and are generally deficient in it. Nephrologist typically stop all parathyroid suppressing medications in the setting described. However, some have suggested what I mention in my question
Answer from: at Academic Institution
I do give calcitriol commonly to ESRD patient who have real low serum calcium levels regardless of their PTH levels. I am not giving it commonly to patients just for osteoporosis but it does make sense it would be helpful in that regardless. The risk of course is inducing low bone turnover bone dise...
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Answer from: at Academic Institution
I believe the general consensus among endocrinologists is that the origin of circulating calcitriol is from the kidney and this is considered the traditional endocrine pathway of vitamin D influencing bone and intestinal mineral absorption. However, many tissues have the ability to synthesize calcit...