Bone Disease- Can daily dialysis halt/reverse?

Lab tests show up problems with calcium and phosphorus balance and high levels of parathyroid hormone (PTH). X-rays and tomography (a special kind of x-ray) show up calcification in soft tissues and blood vessels as well as loss of done density.

Renal bone disease occurs over time and in its early stages there may be no symptoms. Not counting putting calcium in joins that make them knobby and uncomfortable, calcification can cause deposits in lung tissue, stiffening of blood vessels that reduce blood flow and raise blood pressure, and calcium deposits in and on the heart. This is why doctors, dietitians, and other staff constantly encourage people with kidney disease (even before kidney failure) to limit their intake of phosphorus and to take phosphate binders.

Over the years, newer binders have been developed. Today doctors try to avoid aluminum binders that can deposit aluminum in bones causing bone pain and in the brain causing dementia. However, some patients eat too much phosphorus to control their blood levels without aluminum.

For years patients were prescribed binders containing calcium. Research now reports that binders may add to calcification. Newer binders that do not contain calcium are very expensive and unaffordable by many people with kidney disease and kidney failure and some Medicare Part D plans do not cover these products or require people to try less expensive calcium-containing binders first.

Conventional dialysis does not remove enough phosphorus so people with kidney disease must drastically restrict their phosphorus intake. Phosphorus is in many foods that people with kidney disease and kidney failure need to eat, like meat, but also in some foods that people with kidney disease and kidney failure need to limit, like packaged foods, bakery goods, some soft drinks, and dairy products. It appears that nocturnal dialysis done frequently seems to remove more phosphorus allowing more phosphorus dietary intake and sometimes even supplementation.

Here are some images that I found on the Internet that show calcification of tissues.

Visit to read modules about lab tests and nutrition.

Visit to read the K/DOQI guidelines on bone disease.

Beth, thanks for the info on bone disease. Under what circumstances would nephs have patients tested for calcification?

For years people had hand and chest x-rays that showed bone demineralization and calcification of soft tissues. I don’t know if doctors are still having dialysis patients get these or not since I’ve not worked in a dialysis clinic for 10 years. However, annual hand and chest x-rays helped staff show patients on their own x-rays what was happening inside their bodies that they couldn’t feel.

Today there are more precise means of looking for calcification. Read about what are risk factors that should lead doctors to prescribe DEXA (dual energy X-ray absorptiometry) scans. Type in “DEXA” at

According to the guideline for CKD even before kidney failure:

DEXA should be employed in CKD to monitor patients with fractures or those with known risk factors of osteoporosis. These include, but are not limited to: menopause, other causes of gonadal hormone deficiency, smoking, Caucasian race, age greater than 65, and medications such as glucocorticosteroids. Guidelines to treat osteoporosis in the general population are available at Whether these Guidelines are applicable for the treatment of osteoporosis in CKD patients has not been established.

It appears that nocturnal dialysis done frequently seems to remove more phosphorus allowing more phosphorus dietary intake and sometimes even supplementation.

It sure does appear that’s true, if one can judge from bloodwork results. Since starting daily (6 nights in row) nocturnal a year ago, I’ve never had phosphorus which is higher than the normal range even on the pre-treatment bloodwork, let alone the post-treatment one… and that’s with adding phosphorus to my dialysate before every treatment.


I have little hard lumps just beside my chin bone. And I think I have a bit in the tissue on my arms. Hmmm, make that “had”!!! I just had a feel of my arms and its gone. The lumps on my legs have definitely reduced in size. When I first started PD my shoulder calcified. It was actually calcified many years before I started dialysis, but it got better on its own. But when it flared up again oh my god it was the worst pain I have ever experienced. I couldnt move it, and I had to get my other half to dress me lol Imagine a male trying to put your bra on!! hahaha It took about a 2 weeks to get better. It flared up once again a while later. But has been good since.
Now that I think about it, when I was on PD as a teen, my fingers calcified also, very very painful again. Then I had a transplant, and it went away. You could see the size of my knuckles went back to normal.
Since being on nocturnal my phosphate and calcium have been normal. My phosphate actually got too low so I now add phosphate to the dialysate.
They still do xray your hands, I had done not that long ago.

I just had my bone density scan this past Monday. Had the isotope injected just after 08:00…then went for hand’n’feet x-ray, saw the results on screen; went around the hospital - home haemo looking for my script book, as I needed iron & aranesp (EPO), pharmacy where it actually was, but not ready; late breakfast in the hospital canteen; back to the radiolab to get the scan, saw the finished images on the screen; back to pharmacy to collect & pay for scripts; left around 13:00
The radiolab lady told me it was suppposed to be a base-line scan before nocturnal, but I’ve been on 2 months now. Couldn’t see any white spots of calcification. But I had shoulder probs (amongst other places) for a long while before I started nocturnal: now, I’d almost forgotten them. A combo of nocturnal & exercise in the pool has improved them??? :slight_smile: Previously I couldn’t raise either of them very far & could not scratch my back at all. Now I can reach some of it. Still have to use the old wooden spoon, particularly when connected up! :smiley:

Nothing like spending your days off in hospital! Glad to hear you can get that wooden spoon around your back! Have you got a picture of that? :lol:

Just maybe calcification is reverseable…

Excessive intake of soft drinks such as Coca-Cola or Pepsi Cola can stimulate de-calcification in living organisms, according to physicians’ reports and consumer watchdogs

In regards to drinking soft drinks, on the news channels here in US a while back they said that studies showed children who drank colas had weaker bones. The reason wasn’t because of the soda directly. The kids were drinking soda instead of milk. Lin.

It is true, espcially for the girls…however, sodas contain a number of ingredients that are not good when taken excessively…in this case people have the habit of drinking soda all day and nothing else!!! The phosphorous content in sodas pull out the calcium from the bones which is why they become weak…