When kidneys are unable to clear phosphorus from the blood, calcium is drawn from the bones. Retention of this mineral also decreases the secretion of activated Vitamin D3 by the kidney. This vitamin is needed for bone formation.
Taking aluminum-containing medication that binds phosphorus with every meal, initially controls phosphorus. Aluminum can however also contribute to certain bone abnormalities. As kidney function declines, the absorption of calcium is impaired. This and various other factors contribute to a condition called renal bone disease or renal osteodystrophy.
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National Kidney Foundation