Desired PTH, hypophosphatemia, hypercalcemia

Phosphate and Calcium Management

Phosphate and Calcium Management

The use and quantity of calcium binders needs to be reduced to provide normocalcemia and normal phosphate.  Adequate nutrition may be a factor and should be addressed.

PTH Management

PTH Management

Vitamin D sterols

PTH may rise when correcting hypercalcemia and hypophosphatemia are corrected.  An active vitamin D sterol could be introduced or a calcimimetic should be considered if hyperphosphatemia and/or hypercalcemia persist.

Calcimimetics

Other Options of Controversies in Management

This combination may also be seen in dialysis treatments such as frequent nocturnal hemodialysis or short daily hemodialysis with a normal or high dialysate calcium.  Addition of phosphate to the dialysate may be indicated in this situation.

Other Options of Controversies in Management

Other Options of Controversies in Management

This combination may also be seen in dialysis treatments such as frequent nocturnal hemodialysis or short daily hemodialysis with a normal or high dialysate calcium. Addition of phosphate to the dialysate may be indicated in this situation.