hello sir

after few days in dialysis center,i realized dat almost all the patients

there has an elevated parathyroid hormone...what that has connection to

kidney?thank you.

Well its good that you asked that.

Its mainly because most of these CRF patients tend to develop hypocalcemia as the

phosphorus excretion reduces due to renal failure (and calcium too reduces to maintain

the calcium phosphorus product which if it increases to more than 60 can lead to metastatic

calcification). Now once there is hypocalcemia it becomes a feed back for the parathyroid

to excrete more PTH so that the calcium levels in blood are increased. However if this

continues then the bones develop osteodystrophic changes.

So its important to monitor the PTH level to see that it doesn't go up

(this can be prevented by regular calcium supplementation to CRF patients).
Hi sir,


these are few questions asked by my patients and all four of us could not think of the best answer.


1. Tamilvanen complained of palpitation and tachycardia everytime he finishes his haemodialysis session. How do we explain what is he experiencing? What we have thought of is after dialysis, large amount of fluid is taken out from the body and this causes hypotension therefore causes the symptoms.


2. The cost for haemodialysis in India and is it possible of the patient wants to have renal transplant there.

1) Yes what you have thought is correct. Its perhaps because of the volume depletion after HD

2) Its very costly as the govt doesn't pay for it. Around 1000 rupees per session and with weekly 4 sessions its going to be real tough to manage. Yes transplant is available in India and may cost 4-5 lakhs and a relative has to donate his/her kidney.