Tuesday, November 17, 2015

Complications of Chronic Renal Failure

Chronic renal failure often complicated hypertension, anemia, heart failure, pericarditis, cardiomyopathy, hydropower disorders and acid-base balance, renal osteodystrophy, fractures, and infection. In addition to the above complications, the long-term dialysis chronic renal failure may also be complicated by aluminum toxicity, conventional dialysis patients with end-stage renal disease complicated by aluminum toxicity. Many causes of chronic renal failure in hemodialysis patients with regular aluminum poisoning, including: excessive dialysate aluminum content. When the dialysate aluminum content close to 50μg / L, a high incidence of aluminum-related bone disease. Therefore, the authors recommend dialysate aluminum content of at least should be less than 10μg / L, preferably less than 5μg / L. The kidney is the only way to rows of aluminum, chronic renal failure, when absorbed aluminum accumulate in the body may cause aluminum poisoning. End-stage renal disease patients aluminum excretion blocked, more heavy aluminum accumulation in the body, the content of aluminum in the body may be 20 times higher than normal. Aluminum accumulation largest organ is the bone, liver, and spleen. The increase in the aluminum content of bone and aluminum poisoning can lead to aluminum-related bone disease. Aluminum deposited mainly in calcified bone edge, namely the young mineralized bone and non-mineralized bone interface, cause osteomalacia. Osteomalacia histological changes in the degree of severity of the aluminum deposition calcified bone edges related. And aplastic bone disease osteomalacia may be a prelude to aluminum caused. Aplastic bone disease was first reported in 1982, a renal osteodystrophy. Now that this is peritoneal dialysis patients with chronic renal failure, a major bone lesions. Some cases are caused by the excessive accumulation of aluminum, but too much parathyroid hormone suppression may be a more important reason. PTH has an important role in the maintenance of normal bone metabolism. Parathyroid hormones may increase bone transport by preventing deposition of aluminum at the leading edge of mineralization, and parathyroidectomy aluminum-related bone disease is a risk factor for the occurrence, it can reduce bone formation rate and turnover rate , the aluminum accumulation in bone calcification edge, thereby interfering with the process of bone mineralization. Clinically, in patients with secondary hyperparathyroidism parathyroidectomy consider doing before aluminum-related bone disease should be excluded because the deposition of aluminum to reduce parathyroid hormone levels in patients with osteomalacia can accelerate coexist in the bone and accelerates the aluminum-related bone disease occurs. Aluminum-related bone disease in the past reported the incidence was as high as 15% to 25%. In recent years, due to the restrictions on the use of aluminum-containing noticed phosphate binders and improved treatment of dialysate, the incidence rate has decreased significantly.


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