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Book Details
Abstract
The skeleton is a metabolically active organ that undergoes continuous remodeling throughout life. This remodeling is necessary both to maintain the structural integrity of the skeleton and to fulfill its metabolic functions as a storehouse of calcium and phosphorus. Skeletal remodeling can be triggered by changes in mechanical forces or microdamage and by hormonal response to changes in circulating calcium and phosphorus levels. The skeleton also serves as the second line of defense against acidosis, and it is able to liberate buffers in the form of inorganic phosphates. Disorders of Bone and Mineral Metabolism is a multi-authored clinical update that covers all major aspects of bone and its mineral disorders. The first chapter is divided into different sections describing various minerals of clinical importance followed by regulation of mineral metabolism by parathyroid hormone, and vitamin D. There is a very good balance of basic information to act as a primer for the reader and the supporting experimental evidence. The complicated and often difficult topics of mineralization of bone and its regulation and other aspects of mineral metabolism are presented in a particularly clear and interesting manner. A long and useful bibliography follows every chapter. This update contains thorough discussions of the pathophysiology, diagnostic techniques, and therapy of mineral diseases with a wealth of detail. The book is a very useful reference for those interested in bone and mineral physiology and disease, be it a general physician or a nephrologist.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Font Cover | Front Cover | ||
Front Matter | ia | ||
Copyright | id | ||
ECAB Clinical Update:Nephrology | ie | ||
Disorders of Bone &Mineral Metabolism | if | ||
About the Authors | ig | ||
Contents | ii | ||
ECAB Clinical Update InformationDISORDERS OF BONE & MINERALMETABOLISM | i | ||
Introduction | 2 | ||
Renal Osteodystrophy | 2a | ||
ABSTRACT | 2a | ||
KEYWORDS | 2b | ||
Introduction | 2a | ||
Regulation of Bone Resorption and Formation | 3 | ||
Systemic Hormones | 3 | ||
Calcitonin | 4 | ||
1,25(OH)2 Dihydroxyvitamin D3 | 4 | ||
Estrogens | 5 | ||
Glucocorticoids | 6 | ||
Growth Factors and Cytokines | 6 | ||
Transforming Growth Factor | 6 | ||
Bone Morphogenetic Proteins | 6 | ||
Fibroblast Growth Factors | 7 | ||
Cytokines | 7 | ||
Interleukin-6 | 7 | ||
Prostaglandins | 7 | ||
Conclusion | 7 | ||
Introduction | 8 | ||
Histological Patterns of Renal Osteodystrophy | 12 | ||
Osteitis Fibrosa (Predominant Hyperparathyroid Bone Disease) | 13 | ||
Mild Lesion | 13 | ||
Osteomalacia | 14 | ||
Mixed Uremic Osteodystrophy | 14 | ||
Adynamic Bone Disease (Low Turnover) | 14 | ||
Osteoporosis in Chronic Kidney Disease | 15 | ||
Bone Loss and Fracture in Chronic Kidney Disease | 16 | ||
Risk Factors for Bone Loss and Fracture | 16 | ||
Pathogenesis of Renal Osteodystrophy | 17 | ||
Increased Renal Phosphate Retention | 17 | ||
Decreased Renal Calcitriol Production | 18 | ||
Decreased Vitamin D Action on Parathyroid Glands | 19 | ||
Pathogenetic Factors in Osteomalacic Renal Osteodystrophy | 20 | ||
Clinical Signs and Symptoms of Osteodystrophy | 20 | ||
Clinical Features - Adults | 20 | ||
Bone Pain | 20 | ||
Myopathy | 20 | ||
Pruritus | 21 | ||
Calciphylaxis | 21 | ||
Arthritis and Periarthritis | 21 | ||
Spontaneous Tendon Rupture | 22 | ||
Skeletal Deformities | 22 | ||
Growth Retardation | 22 | ||
Evaluation | 22 | ||
Radiographic Features of ROD | 22 | ||
Secondary Hyperparathyroid Bone Disease | 22 | ||
Osteomalacia | 23 | ||
Extraskeletal Calcifications | 23 | ||
Bone Activity Markers | 23 | ||
Alkaline Phosphatase | 23 | ||
25(OH) Vitamin D | 24 | ||
Serum Biomarkers | 24 | ||
PTH | 25 | ||
DEXA Scan | 25 | ||
Bone Mineral Density | 26 | ||
Biochemical Investigations | 30 | ||
Bone Biopsy | 30 | ||
Check List Prior to Bone Biopsy | 30 | ||
Baseline Diagnosis and Biochemical Profile of Study Population | 33 | ||
Bone Densitometry Analysis: Pattern of BMD in ESRD Study Group | 34 | ||
Correlation of BMD with Demographic Profile | 36 | ||
Correlation with Duration of Dialysis | 36 | ||
Correlation with Sex | 36 | ||
Correlation with Age | 37 | ||
Correlation with BMI | 38 | ||
Prevalence of Fracture | 38 | ||
BMD of Control versus ESRD Study Group | 38 | ||
Correlation of BMD with Biochemical Profile | 39 | ||
Spectrum of Bone Histology in ESRD Group | 39 | ||
Intimate Approach to Pathophysiology of Renal Osteodystrophy- High-turnover Bone Disease | 59a | ||
ABSTRACT | 59a | ||
KEYWORDS | 59b | ||
Introduction | 59a | ||
Calcium/Phosphate Homeostasis | 60 | ||
Vitamin D | 60 | ||
Parathyroid Hormone | 60 | ||
Calcitonin | 60 | ||
Bone Remodeling and Molecular Regulation | 61 | ||
Behavior Of Disease | 62 | ||
High-turnover Bone Disease | 63 | ||
Molecular Pathophysiology | 63 | ||
Histopathology | 65 | ||
Histologic Hallmarks | 66 | ||
Roentgenology | 66 | ||
Roentgenologic Hallmarks | 66 | ||
Conclusion | 68 | ||
Adynamic Bone Disease | 69a | ||
ABSTRACT | 69a | ||
KEYWORDS | 69b | ||
Definition | 69a | ||
Prevalence of Adynamic Bone Disease | 70 | ||
Pathogenesis | 70 | ||
Clinical Features and Biochemical Profile | 71 | ||
Long-Term Consequences of ABD | 71 | ||
Management | 73 | ||
Conclusion | 74 | ||
Osteomalacia | 76a | ||
ABSTRACT | 76a | ||
KEYWORDS | 76a | ||
Causes | 76a | ||
Other Causes | 76a | ||
Symptoms | 77 | ||
Diagnosis | 77 | ||
Treatment | 78 | ||
Ergocalciferol | 78 | ||
Calcium Phosphate (Tribasic) | 78 | ||
Calcium Lactate | 78 | ||
Calcium Glubionate | 79 | ||
Cholecalciferol | 79 | ||
Tumor-Induced Osteomalacia (Oncogenic Osteomalacia) | 82 | ||
Investigation | 82 | ||
Diagnosis | 82 | ||
Treatment | 82 | ||
Case Study Disorders of Mineral Metabolism in a Case of Renal Transplant | 83 | ||
Calcitriol in Chronic Kidney Disease | 86a | ||
ABSTRACT | 86a | ||
KEYWORDS | 86a | ||
Calcitriol on Nervous System | 86a | ||
Calcitriol in Cardiac Function | 87 | ||
Calcitriol on Parathyroid Gland | 87 | ||
Calcitriol on Carcinogenesis | 87 | ||
Colon Carcinogenesis | 87 | ||
Prostate Cancer | 87 | ||
Pulmonary Cancer | 88 | ||
Immunoregulatory Function of Calcitriol | 88 | ||
Calcitriol in Chronic Renal Disease | 88 | ||
Metabolism | 88 | ||
Receptor Regulation | 89 | ||
SHPT and Calcitriol | 89 | ||
Conclusion | 89 | ||
Nephrolithiasis | 93a | ||
ABSTRACT | 93a | ||
KEYWORDS | 93b | ||
Introduction | 93a | ||
Pathogenesis | 93a | ||
Signs and Symptoms | 94 | ||
Evaluation | 95 | ||
History and Examination | 95 | ||
Laboratory Evaluation | 96 | ||
Radiology | 96 | ||
Etiology of Nephrolithiasis | 98 | ||
Calcium Metabolism | 98 | ||
Primary Hypercalciuria and Bone Disease | 99 | ||
Management of Hypercalciuria | 100 | ||
Oxalate Metabolism | 101 | ||
Uric Acid | 102 | ||
Hyperuricosuric Calcium Nephrolithiasis (HUCN) | 102 | ||
Cystine | 102 | ||
Infection Related Stones | 103 | ||
Drug-Induced Nephrolithiasis | 103 | ||
Summary | 104 | ||
Management of Patients with Renal Bone Disease | 108a | ||
ABSTRACT | 108a | ||
KEYWORDS | 108a | ||
Dietary Phosphate Restriction | 108a | ||
Phosphate Binders | 109 | ||
Aluminium | 109 | ||
Calcium-based Binders | 109 | ||
Non-aluminium, Calcium, Magnesium Binders | 110 | ||
Sevelamer | 110 | ||
Lanthanum Carbonate | 110 | ||
Nicotinamide | 111 | ||
Vitamin D and Analogs | 114 | ||
25 Vitamin D | 114 | ||
1,25-Vitamin D | 114 | ||
Additional Benefits of Vitamin D | 115 | ||
Calcimimetic Agents | 116 | ||
Parathyroidectomy | 116 | ||
Other Books in This Series | 120 |