Latest Blogs

Case of the Month

  March 2014

A 58 year old Caucasian woman with recurrent pyelonephritis has been on haemodialysis for 20 years. She sustained a low impact fracture of neck of femur but dual energy x-ray absorptiometry (DXA) revealed abnormal bone mineral density (BMD) with clinically significant osteoporosis. Intact parathyroid hormone (PTH) ranged between 80 and 100pg/mL (20 -40ng/L) since parathyroidectomy 8 years ago for secondary hyperparathyroidism. Other laboratory results showed serum calcium 9.9mg/dL (2.47mmol/L), phosphate 5.6mg/dL (1.80mmol/L), total alkaline phosphatase 105U/L, and a low 25-hydroxyvitamin D 10.3ng/mL (25.7nmol/L). 

What is the next best step in management

Read: 320 times Answered: 103 times Top score: 100%

Current Discussions

    • Mahmoud's Avatar
    • Dear Dr Mohamed I'm a bit confused the CT venography didn't report on the subclavian veins ? I think you should ask the opinion of an interventional radiologist for repeat venography ! and...
    • 9 hours 11 minutes ago
    • Mohamed_Aly's Avatar
    • 70 yrs, female, DM, HTN, hist of non sustained VT,bronchial asthma ,ESRD ON HD, hist of renal transplant from 1999 till 2013 , then restart HD , again , through left permicath . recently she...
    • 10 hours 14 minutes ago
    • arif.khwaja's Avatar
    • Acute Rejection in a girl with...
    • I think a biopsy is important but if you have problems getting a good interpretation of the biopsy locally then can you send it somewhere?.. This will still be cheaper than give Rituximab or plasma...
    • 2 days 16 hours ago
    • khvan's Avatar
    • Acute Rejection in a girl with...
    • We started Kidney transplantation only 2 years ago and still have problems with biopsy reading and immunological tests. For now we can do only ELISA Leucocytes antibodies Test. So, for this patient...
    • 2 days 17 hours ago

OLA activity

SupportersLa Sociedad Latinoamericana de Nefrología e Hipertensión European Renal Association - European Dialysis and Transplant Association International Nephrology Education Foundation Arab Society of Nephrology and Renal Transplantation Global Kidney Academy