Dr. Agar,
Although my elevated alk. phos soared down 50 points when I got a slightly higher dose of vitamin D months back, it then remained in a holding pattern, still elevated but much less. There has been no change all this time until this week when I could not dialyze 2 out of 6 nights due to a machine issue. We did labs at the end of the week and my alk phos had come down another 23 points. Wondering if there is any relationship between the loss of dialysis time and the lowered alk phos.? I did not get my PTH result yet, but I am guessing it is up another level considering the last time we did PTH it was heading upward, but it had been decided not to increase the dose yet.