Haldimann B, Flury W
Schweiz Med Wochenschr. 1977 Aug 13;107(32):1113-8.
The prophylaxis and treatment of renal osteodystrophy are based on pathophysiological principles. Development of secondary hyperparathyroidism should be averted by early prevention of hyperphosphatemia through diet and phosphate ligants, and by normalization of the calcium balance through calcium supplements and vitamin D or its analogues. This treatment requires close clinical and laboratory control in order to avoid several hazards (hypercalcemia, hypophosphatemia, and refractory constipation). In cases with severe secondary hyperparathyroidism, subtotal parathyroidectomy is sometimes required. Nevertheless, in one such case this operation resulted in sudden hypoparathyroidism two years postoperatively.
肾性骨营养不良的预防和治疗基于病理生理原则。应通过饮食和磷结合剂早期预防高磷血症，并通过补充钙和维生素D或其类似物使钙平衡正常化，以避免继发性甲状旁腺功能亢进的发生。这种治疗需要密切的临床和实验室监测，以避免多种风险（高钙血症、低磷血症和难治性便秘）。对于严重继发性甲状旁腺功能亢进的病例，有时需要进行甲状旁腺次全切除术。然而，在其中一例这样的病例中，该手术在术后两年导致了突然的甲状旁腺功能减退。
