RESUMO
Renal osteodystrophy is common in chronic renal failure[CRF]. The retention of phosphate, the diminished production of calcitriol, the hypocalcaemia and the increased level of parathormone[PTH] are inter-related and basic pathogenetic factors 25 patients [14 male and 11 female] with average age of 51.7 +/- 10 years, all having moderate renal failure [glomerular filtration rate between 30-70 mI/minute] were included in this study, The basal serum level of calcitriol D3PTH, calcium[ca], phosphorus [p], creatinine, urea and albumin, also the basal urinary level of p, ca and creatinine were determined. The patients were subjected to special dietary regemen with restriction of p by giving special menus for 3 months, the level of the previously mentioned parameters were re-estimated. The p/creatinine index was used to evaluate the fulfilment of the diet. The basal level of PTH was 76.4 +/- 34 pg/ml [normal range 10-65], calcitriol was 21.6 +/- 3.4 pg/ml [normal range 20-45]. After dietary p restriction the mean level of PTH descended significantly, 74% of the patients showed reduction of PTH. The mean level of calcitriol rose significantly after the diet, all the patients showed an increase in their level. A moderate restriction of p in the diet has produced an improvement of the level of serum calcitriol, obtaining a level similar to that of healthy subjects, also reduction of the level of PTH has been obtained near the normal range. This diet represent an easy therapeutic maneuver and without cost In the way of prevention of secondary hyperparathyroidism and consequent osteodystrophy in patients with CRF