EVALUATION OF BONE MINERAL DENSITY AND CALCIUM SCORE IN HEMODIALYSIST PATIENTS

Origin of renal osteodystrophy and cardiovascular complications are multifactorial. This complications are caused by disorders of calcium - phosphate metabolism already at the beginning of patient's irreversible renal failure. The factors playing the most important part in the development o renal ostedystrophy and are hypocalcemia and increasing serum phosphate levels associated with a declining glomerulal filtration. Two main types of renal osteodystrophy can be described - high turnover bone disease and low turnover disease. High turnover forms of renal osteodystrophy are characterized by rapid bone turnover caused by abnormally high PTH levels. The two types of high turnover renal osteodystrophy are predominant hyperparathyroid bone disease, and mixed uremic osteodystrophy. Low turnover forms of renal osteodystrophy are characterized by a dramatic drop in the rate of bone remodeling, caused by oversuppression of PTH and/or by aluminum accumulation. The bones become thin and overly flexible, and bowing may occur. The two types of low turnover renal osteodystrophy are low turnover uremic osteodystrophy and aluminum-related bone disease. Patients who have end-stage renal disease with increased serum phosphate levels and calciumphosphate products are associated with an increased prevalence of ectopic..