Abstract | BACKGROUND: METHODS: RESULTS: High turnover renal osteodystrophy (ROD) was the most common bone disease, present in eight patients (47%). Five patients (29%) had low turnover bone disease, and four (24%) had mixed ROD. The mean age of the high turnover ROD group was higher than that of the low turnover group (14 +/- 3 vs. 11 +/- 3 years, P < 0.05). Seven of the nine patients who had tubulo- interstitial nephritis were found to have high turnover bone disease. In contrast, none of the patients with glomerulonephritis exhibited high turnover bone lesions. Mean serum calcium levels were found to be significantly higher in the low turnover group compared with the patients with high turnover bone disease (P < 0.001). A serum iPTH level > 200 pg/mL was 100% sensitive and 66% specific in identifying patients with high turnover ROD. CONCLUSION: The spectrum of bone disease of the children with CRF undergoing CAPD seems to depend on the rate of CRF and primary disease. The risk of developing overt hyperparathyroid bone disease is high in children with slowly progressing forms of renal pathology and especially in those with tubulo-interstitial disease. In contrast, children with glomerular diseases who had a more rapidly progressive course may have a lesser risk of developing high turnover bone disease. The results of the present study indicate that even routinely prescribed regular vitamin D therapy early in the course of disease may lead to low turnover bone lesion in small children who have CRF due to rapidly progressive forms of renal pathology.
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Authors | F Yalçinkaya, E Ince, N Tümer, A Ensari, N Ozkaya |
Journal | Pediatrics international : official journal of the Japan Pediatric Society
(Pediatr Int)
Vol. 42
Issue 1
Pg. 53-7
(Feb 2000)
ISSN: 1328-8067 [Print] Australia |
PMID | 10703235
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Biopsy
- Bone Remodeling
- Bone and Bones
(metabolism, pathology)
- Calcium
(blood, metabolism)
- Child
- Chronic Kidney Disease-Mineral and Bone Disorder
(classification, etiology, metabolism, pathology)
- Cross-Sectional Studies
- Humans
- Kidney Failure, Chronic
(complications, therapy)
- Peritoneal Dialysis, Continuous Ambulatory
- Risk Factors
- Vitamin D
(therapeutic use)
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