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ROLE OF 25 HYDROXYVITAMIN D AND PTH IN CHRONIC RENAL FAILURE: NEW TARGETS AND NEW THERAPIES

Glendenning, Paul

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Pathology - Journal of the RCPA: 2010 - Volume 42 - Issue - p S21
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Suboptimal levels of 25 hydroxyvitamin D (25OHD) are common in haemodialysis patients (CKD‐5D) and may be associated with reduced muscle strength, increased falls risk and fractures. Reasons for suboptimal 25OHD in CKD‐5D will be explored in this presentation and the association between 25OHD, 1,25 dihdroxyvitamin D, PTH and renal function will be examined. The increased risk of hip fracture in dialysis patients will be demonstrated and data exploring the hypothesis that 25OHD levels may be independently associated with falls risk in CKD‐5D will be examined. Whilst supplementation with calcium and cholecalciferol reduces hip and other non‐vertebral fractures in elderly individuals, in part attributable to reduction in falls, the relationship between 25OHD and falls risk has not been investigated in CKD‐5D in the past. Consequently, in addition to the traditional endocrine role for vitamin D, that requires renal conversion of 1,25 (OH)2D, circulating levels of 25OHD may play a more important and direct auto/paracrine role in muscle metabolism, both in people with normal renal function and those on dialysis.

© 2010 Royal College of Pathologists of Australasia