Renal osteodystrophy in children on CAPD: a prospective trial of 1-alpha-hydroxycholecalciferol therapy.

Abstract	The efficacy of 1 alpha-hydroxycholecalciferol in the prevention of renal osteodystrophy in children commencing continuous ambulatory peritoneal dialysis was studied in 12 patients, 0.8-17 years of age, who were randomly assigned to either group I receiving standard therapy or to group II receiving in addition 10-20 ng/kg body weight/day of 1 alpha-hydroxycholecalciferol. Calcium carbonate compounds were used to control hyperphosphataemia. Mean plasma calcium (total and ionised) and phosphate levels were not significantly different between the two groups. All group I patients continued to have elevated plasma immunoreactive parathyroid hormone levels at 6 months compared to only 1 patient in group II (p less than 0.05). Four patients in group I developed subperiosteal erosions on radiography compared to the healing of mild lesions in 2 patients in group II. Bone histomorphometry on iliac crest needle biopsy specimens revealed a significant reduction in osteoid index and seam width in group II. Serum aluminum levels decreased during the course of continuous ambulatory peritoneal dialysis, and the significant staining for bone aluminum in 6 patients at the beginning of the study was no longer present in 5 patients at 6 months. Our data demonstrate that 1 alpha-hydroxycholecalciferol is beneficial in the prevention and treatment of bone disease in children on continuous ambulatory peritoneal dialysis.
Authors	A R Watson, S W Kooh, C S Tam, B J Reilly, J W Balfe, R Vieth
Journal	Child nephrology and urology (Child Nephrol Urol) 1988-1989 Vol. 9 Issue 4 Pg. 220-7 ISSN: 1012-6694 [Print] Switzerland
PMID	3255485 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References	Hydroxycholecalciferols Phosphates Aluminum Calcium Carbonate Calcium alfacalcidol
Topics	Adolescent Aluminum (blood) Calcium (blood) Calcium Carbonate (therapeutic use) Child Child, Preschool Chronic Kidney Disease-Mineral and Bone Disorder (blood, diagnostic imaging, drug therapy) Female Humans Hydroxycholecalciferols (therapeutic use) Infant Male Peritoneal Dialysis, Continuous Ambulatory Phosphates (blood) Prospective Studies Radiography Random Allocation

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