Monday, June 27, 2011


Serum calcium is monitored closely in patients with ESRD. There
is a delicate interplay between serum calcium, ionized calcium, serum
phosphorus, PTH, and vitamin D. Because of this, it is desirable for the
dietitian to work with the nephrologist to determine need for and adequacy
of calcium supplementation. Some phosphate binders are calcium based and can
be a problematic by elevating serum calcium levels too much. Using a
noncalcium containing phosphate binder may be preferable in hemodialysis
patients. Monitoring bone mineralization markers may be of assistance in
this determination,

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