My parathyroid hormone (PTH) level is rising and my Zemplar dose increasing. Is this normal?
This is a complex problem and, without knowing specific details of you case, your duration of renal failure and/or any previous dialysis history, the details of the NHHD program you are on (frequency and hours etc), your prior treatment and a whole lot more about your biochemistry, I cannot give you a ‘you-specific’ answer but, in broad terms, the problem may be as follows ……………. NHHD will control your blood phosphate. There is no question of this. We know that a raised phosphate is an independent risk factor to progressive bone and cardiovascular disease and that its control by NHHD is a major advance and advantage for you. You should by now be off phosphate binders – these are usually withdrawn at the start of NHHD and your phosphate level should now be well within the normal range. But … If you have had long periods of poorly controlled phosphate level (high levels) prior to NHHD, this will have induced hypocalcaemia (a lowering of the calcium level) and a resulting stim
