The bone and mineral disorder of children undergoing chronic peritoneal dialysis
| Autor: | Pedro Zambrano, Hui-Kim Yap, Ana P. Spizzirri, Nikoleta Printza, Patricia G. Vallés, Sevcan A. Bakkaloglu, Dagmara Borzych, Mustafa Bak, Pankaj Hari, Maria Lipka, Lesley Rees, Günter Klaus, Franz Schaefer, Andrea Vogel, Thurid Ahlenstiel, Gema Ariceta, Fatih Ozaltin, Il Soo Ha, Bradley A. Warady, Annabelle Chua, Laura Lopez |
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| Přispěvatelé: | Çocuk Sağlığı ve Hastalıkları |
| Jazyk: | angličtina |
| Předmět: |
Nephrology
Male medicine.medical_specialty Adolescent medicine.medical_treatment Parathyroid hormone Naphthalenes Gastroenterology Peritoneal dialysis Hyperphosphatemia Young Adult pediatric nephrology Internal medicine chronic dialysis medicine Humans Osteodystrophy Prospective Studies Registries Vitamin D Child Dialysis phosphate Hypocalcemia business.industry Infant Phosphorus Phosphate-Binding Proteins Urology & Nephrology medicine.disease Europe Endocrinology Latin America Cinacalcet Hydrochloride Parathyroid Hormone Child Preschool North America Kidney Failure Chronic Calcium Female renal Cinacalcet business Peritoneal Dialysis Kidney disease Follow-Up Studies |
| Zdroj: | Kidney International. (12):1295-1304 |
| ISSN: | 0085-2538 |
| DOI: | 10.1038/ki.2010.316 |
| Popis: | The mineral and bone disorder of chronic kidney disease remains a challenging complication in pediatric end-stage renal disease. Here, we assessed symptoms, risk factors and management of this disorder in 890 children and adolescents from 24 countries reported to the International Pediatric Peritoneal Dialysis Network Registry. Signs of this disease were most common in North American patients. The prevalence of hyperphosphatemia increased with age from 6% in young infants to 81% in adolescents. Serum parathyroid hormone (PTH) was outside the guideline targets in the majority of patients and associated with low calcium, high phosphorus, acidosis, dialysis vintage and female gender. Serum calcium was associated with dialytic calcium exposure, serum phosphorus with low residual renal function and pubertal status. PTH levels were highest in Latin America and lowest in Europe. Vitamin D and its active analogs were most frequently administered in Europe; calcium-free phosphate binders and cinacalcet in North America. Clinical and radiological symptoms markedly increased when PTH exceeded 300 pg/ml, the risk of hypercalcemia increased with levels below 100 pg/ml, and time-averaged PTH concentrations above 500 pg/ml were associated with impaired longitudinal growth. Hence, the symptoms and management of the mineral and bone disorder of chronic kidney disease in children on peritoneal dialysis showed substantial regional variation. Our findings support a PTH target range of 100-300 pg/ml in the pediatric age group. Kidney International (2010) 78, 1295-1304; doi:10.1038/ki.2010.316; published online 1 September 2010 |
| Databáze: | OpenAIRE |
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