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MY TREATMENT:
KNOWING MY LAB NUMBERS
Knowing what your lab numbers are helps you to see how your body is doing with dialysis. The clinic will draw and review your labs (chemistry and blood counts) at least once a month. These lab tests look at several things including the phosphorus, calcium, and parathyroid hormone (PTH) levels in your blood, and that you are getting enough dialysis. PHOSPHOROUS
gets into your blood by “binding” to the phosphate in your digestive tract to make a compound that is not absorbed Your phosphorus level goal is to be within the normal values of 3.0
to 5.0mg/dl.
Some examples of phosphate binders are Calcium Carbonate Symptoms Related to High Phosphorus Levels
(Tums), Calcium Acetate (Phoslo), Sevelamer (Renvela) and • Itching that you cannot relieve • Red eyes Your calcium level goal is to be within the normal values
Serious Complications of Uncontrolled Phosphorous
of 8.5 to 10.4 mg/dl.
Symptoms Related to High Calcium Levels
• Heart disease with increased risk of death • Mineral deposit build up in kidneys, heart, lungs, eyes, skin, and blood Causes of High Phosphorous Levels
• Not taking the medication known as phosphate binders with your meals Causes of High Calcium Levels
• Inadequate dialysis by missed treatments or shortened treatment time • Medications containing calcium or vitamin D
Symptoms Related to Low Calcium Levels
Treatment with Phosphate Binders
Phosphate binders help to get excess phosphate out of your body in your stool. These medicines lessen the amount of phosphate that For more information or to file a grievance please contact the Heartland Kidney Network at: Heartland Kidney Network • 7306 NW Tiffany Springs Pkwy. • Suite 230 • Kansas City, MO 64153 Toll-Free Patient Line: (800) 444-9965 • [email protected] • www.heartlandkidney.org End-Stage Renal Disease (ESRD) #12 Network Coordinating Council, Inc. dba Heartland Kidney Network .This resource was (created, developed, compiled, etc.) while under contract with Center for Medicare and Medicaid Services, Baltimore, Maryland. Contract #HHSM-500-2010-NW012C. The contents presented do not necessarily reflect CMS policy.
• Hair loss
• Cataracts
Causes of Low Calcium Levels
• Not taking binders with your meals
• Eating food with a lot of phosphorus
PARATHYROID HORMONE (PTH) LEVELS
Your body responds to the abnormal calcium and phosphorous
levels by producing a hormone called Parathyroid Hormone
(PTH) from a gland in the neck known as the parathyroid
gland. High PTH levels cause the gland to work too hard,
which causes secondary hyperparathyroidism. High levels
of PTH contribute to renal bone disease and need to be
controlled.
Your PTH level goal is less than 300pg/ml.
Treatment for secondary Hyperparathyroidism (elevated PTH
levels)
• Limit high phosphorous foods in your diet
• Take phosphate binders to control phosphorous levels
– Vitamin D therapy as directed
– Calcitriol (Rocaltrol or Calcijex)
– Paricalcitol (Zemplar)
– Doxercalciferol (Hectorol)
MY QUESTIONS
Ask your Care Team: What are my labs right now? What can I to improve them? What are some of the other labs I should know about?Source: http://kidney.niddk.nih.gov/kudiseases/pubs/pdf/eatrighthemodialysis.pdfNorris,Keith. “Phosphate Binders: What Are They And How Do They Work?” RENALIFE, Vol.16, No. 5, March 2001. www.aakp.org For more information or to file a grievance please contact the Heartland Kidney Network at: Heartland Kidney Network • 7306 NW Tiffany Springs Pkwy. • Suite 230 • Kansas City, MO 64153 Toll-Free Patient Line: (800) 444-9965 • [email protected] • www.heartlandkidney.org End-Stage Renal Disease (ESRD) #12 Network Coordinating Council, Inc. dba Heartland Kidney Network .This resource was (created, developed, compiled, etc.) while under contract with Center for Medicare and Medicaid Services, Baltimore, Maryland. Contract #HHSM-500-2010-NW012C. The contents presented do not necessarily reflect CMS policy.

Source: http://heartlandkidney.org/article_resources/MyTreatment_KnowingLabNumbers.pdf