Object of this thesis was to analyse the influence of the metabolic acidosis on the progress of the renal osteopathy and the effectiveness of the actual anti-acidotic therapy. Methods: An observation of 137 patients has been conducted over a period of up to 20 quarters. Each quarter 16 parameters have been selected for analysis, i.e. weekly dialysis duration, concentration of creatinine, phosphate, calcium, urea, parathormone and the alkaline phosphatase, parameters of the acid-base balance, various phosphate binding substances, and metabolites of vitamin D. Depending on the medication the patients were divided into six groups. The statistical evaluation was done by Student’s t-Test. Findings: Overall a significant increase of the pH of the blood and the concentration of calcium was found. There was no significant increase of parathormone and phosphate. The concentration of urea decreased significantly. The data analysis within the groups showed a comparable effect regarding the ability to bind phosphate of calcium carbonate and acetate and magnesium carbonate. Bearing lower risks of hypercalcaemia, magnesium carbonate can be treated well on patients with high calcium levels. The data retrieval of the group treated with magnesium carbonate shows the parathormonesuppressing effect of magnesium, which previously has been observed on other studies. Comparing the data from the patients treated with 1á-(OH)-D3 intravenous or orally, the intravenous therapy bears a lower risk of hypercalcaemia and therefore has a higher therapeutical security. Conclusion: The retrieved data confirms the importance of the anti-acidotic therapy (diet, concentration of bicarbonate of the dialysate) for patients undergoing hemodialysis. The anti-acidotic therapy combined with phosphate binding medication and vitamin-D3-metabolites effectively reduces the progression of renal osteopathy. |