Scenario 3: A 62-year-old man, who has been on for 10 years, presents with gradually increasing bone pain. Current medications include alfacalcidol 1 mcg/day and calcium carbonate 1500 mg. The patient’s labs are shown in table 1 Test Value S. Creatinine 3.9 mg/dL S. corrected Calcium 10.5 mg/dL S. Phosphorus 7.1 mg/dL iPTH 18 pg/mL […]
Scenario 2 – Part 2: The above-mentioned bone biopsy study recruited another patient with ESKD who underwent parathyroidectomy 12 months ago with a similar preoperative clinical profile. However, he developed progressive cognitive dysfunction a few months post-parathyroidectomy. The bone histopathological pictures are presented in figure 2 &3. figure 2 figure 3 figure 3 is stained […]
Scenario 2 – Part 1: A 54-year-old male, ESKD on maintenance hemodialysis for three years, who underwent parathyroidectomy 12 months ago, was asked to participate in a bone biopsy pilot study, investigating the spectrum of bone histopathological changes in patients who underwent parathyroidectomy through the past twelve months. The patient’s labs are shown in table […]
Scenario 1 – Part 2: The vitamin D level was 14 ng/ml.The patient has been started on 50000 IU of ergocalciferol weekly and calcium carbonate. Six months later, the patient’s labs were as follows: Test Value S. Creatinine 3.7 mg/dL S. corrected Calcium 8.6 mg/dL Phosphorus 7.1 mg/dL PTH 400 pg/mL The patient had persistently […]
Scenario 1 – Part 1: A 52-year-old woman with end stage kidney disease secondary to hypertension complains of feeling increasingly bony aches and tiredness. She is currently receiving renal replacement therapy via hemodialysis. Her current medications include ramipril, aspirin, calcium carbonate and erythropoietin. On examination, the pulse rate is 73 – regular and the blood […]
