Nephrology

Bone and Calcium Disorders

Questions discussed in this category

How do you decide when to treat hypocalcemia in hospitalized patients?

What is your approach to treating hypercalcemia secondary to immobilization?

Do you set specific goals related to mobility, volume management, and vitamin D levels? When do you consider medications such as bisphosphonates, calc...

1 Answer available

Given the risk of hypocalcemia in dialysis dependent patients treated with denosumab, what is the best method of treatment for osteoporosis for these patients, and should we be transitioning to a different agent?

2 Answers available

What is your approach to IV fluid management for the treatment of hypercalcemia of malignancy?

Is there an advantage between saline and LR?

1 Answer available

Under what circumstances would you consider a bone biopsy in the workup of renal osteodystrophy?

Lafage-Proust et al., PMID 40446949

1 Answer available

What are some practical tips in distinguishing between metabolic bone disease due to chronic kidney disease and osteoporosis?

1 Answer available

Do you prefer kidney ultrasound or a non-contrast CT scan to evaluate for nephrolithiasis in an asymptomatic patient with primary hyperparathyroidism?

1 Answer available

Which method provides a more accurate assessment of hypercalciuria: 24-hour urinary calcium excretion or the spot urine calcium-to-creatinine ratio?

2 Answers available

Do you temporarily hold diuretics when measuring 24-hour urine calcium levels in the evaluation of primary hyperparathyroidism?

3 Answers available

How do you approach vitamin D supplementation in patients with chronic kidney disease, given the findings that vitamin D2 supplementation may lead to decreased conversion of 25-hydroxyvitamin D3 to 1,25-dihydroxyvitamin D3?

Batacchi et al., PMID 28768705

1 Answer available

Is there a role for cinacalcet in the management of PTHrP-mediated hypercalcemia?

1 Answer available

What is the recommended workup for PTH-independent hypercalcemia secondary to an elevated 1,25-dihydroxyvitamin D level?

1 Answer available

For a patient with idiopathic hypercalciuria and a history of calcium kidney stones who has not normalized 24-hr urine calcium level on thiazide diuretic, is there evidence for targeting a certain urine calcium level for decreased future risk of nephrolithiasis and osteoporosis?

2 Answers available

What treatment options would you consider for a young patient with limited mobility, low bone mass and multiple vertebral compression fractures who is on dialysis for advanced kidney disease?

1 Answer available

Is there a role for calcitriol in dialysis patients regardless of PTH level?

Calcitriol has important non-bone effects and dialysis patients can’t make it and are generally deficient in it. Nephrologist typically stop all...

2 Answers available

Would you stop denosumab in a patient with chronic kidney disease if they develop asymptomatic hypocalcemia after the injection?

4 Answers available

Would you order a repeat DEXA scan 1 year later for a kidney transplant patient who had an initial DEXA scan within the first 6 months post-transplant showing osteopenia but no history of fractures, and who has been stable on glucocorticoid-free immunosuppressive therapy?

2 Answers available

Does vitamin D supplementation in primary hyperparathyroidism increase the risk of kidney stones?

Is this seen more with high dose vitamin D supplementation?

1 Answer available

Do you recommend parathyroid imaging testing for patients with recurrent nephrolithiasis who are incidentally found to have an elevated PTH but who do not have hypercalciuria, hypercalcemia, hypovitaminosis D, or chronic kidney disease?

2 Answers available

What is your approach to managing patients with recurrent nephrolithiasis and nephrocalcinosis in the setting of hypoparathyroidism?

1 Answer available

What is your approach to managing osteoporosis in patients with end stage kidney disease?

1 Answer available

How do you distinguish between primary and tertiary hyperparathyroidism in a patient with ESRD?

1 Answer available

How long do you wait before reassessing a 24 hour urine calcium level in patients with recurrent nephrolithiasis, hypercalciuria, and osteoporosis who are initiated on bisphosphonate therapy?

3 Answers available

Papers discussed in this category

Clinical journal of the American Society of Nephrology : CJASN, 2017-08-07

Low Bone Density and Bisphosphonate Use and the Risk of Kidney Stones.

The New England journal of medicine, 1980-02-21

The importance of circulating 1,25-dihydroxyvitamin D in the pathogenesis of hypercalciuria and renal-stone formation in primary hyperparathyroidism.

The New England journal of medicine, 2018 Sep 13

Primary Hyperparathyroidism.

Advances in nutrition (Bethesda, Md.), 2021 Oct 01

Vitamin D: Nutrition Information Brief.

The Journal of clinical endocrinology and metabolism, 2013-03

Serum concentrations of 1,25-dihydroxyvitamin D2 and 1,25-dihydroxyvitamin D3 in response to vitamin D2 and vitamin D3 supplementation.

Clinical journal of the American Society of Nephrology : CJASN, 2017-09-07

Effects of Vitamin D2 Supplementation on Vitamin D3 Metabolism in Health and CKD.

Nephrology

Bone and Calcium Disorders

Questions discussed in this category

Papers discussed in this category

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