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Vitamin and mineral management for dialysis patients is a required treatment for people undergoing dialysis because during end-stage kidney disease and dialysis the kidneys are functioning at less than 15% of normal levels. [1] As a consequence, certain vitamin and mineral restrictions and supplementations are needed. [2]
The conversion of 25(OH) vitamin D to 1,25(OH)2 vitamin D is impaired, reducing intestinal calcium absorption and increasing PTH. [2] The kidney fails to respond adequately to PTH, which normally promotes phosphaturia and calcium reabsorption, or to FGF-23, which also enhances phosphate excretion. [2]
[4]: 100–101, 371–379 [5] [33] The prevalence of vitamin D deficiency increases with age due to a decrease in 7-dehydrocholesterol synthesis in the skin and a decline in kidney capacity to convert calcidiol to calcitriol, [34] the latter seen to a greater degree in people with chronic kidney disease. [35]
Renal osteodystrophy is usually diagnosed after treatment for end-stage kidney disease begins; however the CKD-MBD starts early in the course of CKD. [1] [6] In advanced stages, blood tests will indicate decreased calcium and calcitriol (vitamin D) and increased phosphate, and parathyroid hormone levels. In earlier stages, serum calcium ...
[4] [15] Patients with osteoporosis, chronic kidney disease, malabsorption, obesity, and some other infections may be at greater risk for being vitamin D-deficient and so are more likely to have this test. [15] Although vitamin D deficiency is common in some populations including those living at higher latitudes or with limited sun exposure ...
The kidneys are responsible for converting 25-hydroxyvitamin D to 1,25-hydroxyvitamin D. This is the active form of vitamin D in the body. Kidney disease reduces 1,25-hydroxyvitamin D formation, leading to a deficiency of the effects of vitamin D. [1]