The Role of Bone Biopsy in the Management of CKD‐MBD

According to KDIGO guidelines, what are the 3 components of CKD-MBD? KDIGO changed its recommendations regarding bone biopsy in 2017? What is this change compared to 2009 and what do you think about it? Bone biopsy can give valuable information in CKD; however, it has some limitations. Explain the aforementioned statement. What are abnormalities of […]

Scenario 3 – Part 2: Calcium supplement and alfacalcidol were stopped. The patient was started on sevelamer 1600 mg.with meals TID Two months later, lab showed: Test Value S. Creatinine 5 mg/dl S. corrected Calcium 10.1 mg/dL S. Phosphorus 7.3 mg/dL iPTH 320 pg/mL   D- Are you happy with this response? and why? E- […]

Scenario 3 – Part 1: A 40-years-old male, ESKD for10 years ago. H/O of low trauma fracture of Lt forearm and Lt hip. The patient was maintained on oral alfacalcidol 1 mcg per day and oral calcium gluconate 1000 mg per day. The following laboratory investigations revealed: Test Value S. Creatinine 5 mg/dL S. corrected […]

Scenario 2 – Part 2: The patient underwent reduction and fixation, and the hips were regularly monitored. She was started on vitamin D, calcium, and phosphate replacement. Three months later, the patient was still experiencing hip pains and was unable to ambulate without support.  D- Would you recommend any further investigations and why? E- Discuss […]

Scenario 2 – Part 1: A 78-year-old female who had a 10-months history of hip pain and generalised muscle pain and weakness , presented with right femoral neck fracture. The patient was a strict vegetarian and homebound most of the time. X-ray revealed marked femoral bowing with cortical thickening and bending deformities of the sternum […]