Clinical Case Database / Category: Patient Management
Chronic kidney disease - mineral bone disease
Publication details
Matthew Graham-Brown, David Bennett-Jones, Mohamed Thahir
Foundation Years Journal, volume 5, issue 2, p.9 (123Doc Education, London, March 2011)
Abstract
A 59-year old female, with end-stage renal failure (ESRF) secondary topolycystic kidney disease (APKD) on continuous ambulatory peritoneal dialysis (CAPD), was seen as part of a routine follow-up in outpatients.She complained of tingling around her mouth, as well as numbness andtingling in her fingers. She had been diagnosed with APKD in 1987 and had had 18 months of CAPD before a deceased donor renal transplant in 1992 which failed after 15 years, necessitating her return to CAPD. Her medication consisted of an ACE-inhibitor, a calcium channel blocker, levothyroxine,an active vitamin D analogue and a calcium containing phosphate binder. Her only other medical conditions were hypertension, hypothyroidism andprevious partial parathyroidectomy.
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Authors
Matthew Graham-Brown
FY1 – University hospital Coventry and Warwickshire
MattGB@doctors.org.uk
David Bennett-Jones
Consultant Renal Physician
University hospital Coventry and Warwickshire
Mohamed Thahir
Specialist Registrar Medicine
University hospital Coventry and Warwickshire
References
1. KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder. Kidney Int 2009, 76 ( 113): s1–132.
2. Moe S, Drueke T, Cunningham J et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from kidney disease: Improving Global Outcomes (KDIGO). Kidney Int 2006, 69: 1945–53.
3. Cunningham J. Renal Bone Disease. Medicine 2007, 35:8: 450–52.
4. Malluche H, Faugere M. Renal Bone Disease 1990: an unmet challenge for the nephrologist. Kidney Int 1990, 38: 193–211.
5. Ketteler M, Gross ML, Ritz E. Calcification and cardiovascular problems in renal failure. Kidney Int 2005, 94: S120–127.
6. Fan LS, Cunningham J. Hyperphosphataemia management. Semin Dial 2002,15: 1–3.
7. Naional Kidney Foundation. K/DoQI clinical practice guidelines: bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003, 42 (suppl. 4): S1–S201.
8. Steddon SJ, Cunningham J. Calcimimetics and calcilytics – fooling the calcium receptor. Lancet 2005, 365: 2237–39.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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