Hyperparathyroidism is an invisible killer for kidney patients. CKD is often accompanied by calcium and phosphorus metabolic disorders, which are manifested as hyperphosphatemia and hypocalcemia. If they are not corrected and treated for a long time, they will develop secondary hyperparathyroidism. It is a common complication in patients with chronic kidney disease and one of the most major and serious complications. According to the epidemiological investigation, the incidence of secondary hyperthyroidism accounts for 20%~50% after kidney function impairment. Therefore, we must pay attention to early prevention.
Why do CKD patients have hyperthyroidism?
-Hypocalcemia. With kidney damage and various abnormalities in the regulation of hormones, it's easy to see a drop in blood calcium, which can stimulate hyperparathyroidism.
-Hyperphosphatemia. Because of kidney damage, phosphorus retention increases, and once blood phosphorus is elevated, it also stimulates hyperthyroidism.
-Abnormal metabolism of active vitamin D. The kidney is the main organ for the synthesis of active vitamin D, and when the kidney is damaged, the active vitamin D decreases, causing hyperthyroidism.
-Other factors, such as abnormal hormone metabolism, changes of growth factor, and inflammatory factor and so on.
What harm can secondary hyperthyroidism bring to kidney patients?
-Bone sclerosis is liable to fracture.
-Joint and muscle disorders, such as arthritis, joint redness and swelling, muscle weakness, and severe tendon rupture.
-Skin itching.
-The high incidence of cardiovascular and cerebrovascular diseases, especially in patients with renal failure or long-term dialysis. They are also more prone to vascular calcification, which is also the main cause of death.
Therefore, early diagnosis and correct treatment are very important. Our five methods can effectively control and treat hyperthyroidism.
1. Blood phosphorus control
-Dietary controls: patients are advised to limit their intake of phosphorus to 600 mg per day and to limit consumption of foods high in inorganic phosphorus or high in phosphorus additives.
-To use phosphorus binders. There are a variety of calcium- and calcium-free phosphorous binders, and your doctors can help determine which is best.
2. Blood calcium control. In patients with advanced kidney disease, many have hypercalcemia, and it is easy to see increased calcium load and obvious calcification, so for CKD patients, the application of calcium should follow the doctor's advice.
3. Medication. At present, drugs that can treat hyperthyroidism are divided into two categories, one is active vitamin d-related drugs, and the second is Calcimimetics.
Calcimimetics is a relatively new synthetic drug, which is to inhibit the secretion of parathyroid hormone drugs, and vitamin D is to inhibit the synthesis of parathyroid hormone drugs, and the two drugs are complementary. There is another advantage of Calcimimetics, that is, no side effects of high phosphorus and high calcium, so the combination with vitamin D can make up for each other.
4. Surgery. When there is no obvious improvement after drug treatment, or there is obvious hypercalcemia and hyperphosphatemia during internal medical treatment, and the imaging examination shows that parathyroid gland has increased by more than one centimetre, it suggests that surgical treatment should be carried out as soon as possible.
5. Active treatment of primary disease, which is the top priority. No matter it is surgery or medication, as long as you do not improve your primary kidney disease, all other treatment has the risk of recurrence. Therefore, kidney patients should pay attention to the treatment of primary kidney disease, and follow the principle: early detection, early prevention and early treatment.
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