bone health

[Jane]

Dear Dr. Agar,

My questions are:

1) Do nocturnal length txs improve bone health...should one doing nocturnal txs begin to notice any changes in the PTH, cal., phos balance and other bone issues for the better?

2) Does adjusting the hrs of tx to lets say from 8 hrs to 7 hrs have any affect on the PTH, cal, phos balance?

3) Also, I would like to know if in Australia, measurement of the PTH "ratio", along with PTH, is done as it is done by Scantibodies Labs in the U.S. for supposedly more accurate measurement of PTH? I find their website very informative. Our clinic uses their method, but I don't know any other patients whose nephs use Scantibodies. Not sure if Scantibodies is something we just have here in the U.S or if other countries have something similar.

I know, I know, I'm looking at the #s again, but I really do think like you, Dr. Agar, in that I believe dialysis should be individualized to the patient. If you had ever read any of my posts on this site you would know I have long advocated individualization/optimization and had attempted to get nocturnal txs for years before finally being given the opportunity about a year ago. This girl believes in optimal dialysis whatever that takes and I very much believe in starting with the best so it is possible to look at the big picture overall rather than having to focus on the #s. Unfortunately, that's not how dialysis has been typically done in the U.S. With barely adequate txs being the norm here for most of the patient population, is it any wonder we have been programmed to look at the #s ?!? I am most glad to be turning things around with my txs for the first time. THAT is a good feeling!