Mineral and Bone Disorders in Children with Chronic Kidney Disease

Overview

Journal Nat Rev Nephrol

Specialty Nephrology

Date 2011 Sep 28

PMID 21947120

Citations 12

Authors

Claus Peter Schmitt

Otto Mehls

Affiliations

Soon will be listed here.

Abstract

As children with chronic kidney disease (CKD) have a long lifespan, optimal control of bone and mineral homeostasis is essential not only for the prevention of debilitating skeletal complications and for achieving adequate growth but also for preserving long-term cardiovascular health. As the growing skeleton is highly dynamic and at particular risk of deterioration, close control of bone and mineral homeostasis is required in children with CKD. However, assessment of bone disease is hampered by the limited validity of biochemical parameters-major controversy exists on key issues such as parathyroid hormone target ranges and the lack of useful imaging techniques. The role of newly discovered factors in bone and mineral homeostasis, such as fibroblast growth factor 23, is not yet established. Even though scientific evidence is limited in children with CKD, ergocalciferol or cholecalciferol supplementation and the use of calcium-free phosphate binders is recommended. The new drug cinacalcet is highly promising; however, pediatric experience is still limited to observational data and the effect of cinacalcet on longitudinal growth and pubertal development is unknown. Randomized, controlled trials are underway, including studies of cinacalcet pharmacokinetics and pharmacodynamics in infants.

Citing Articles

Diagnosis and management of mineral and bone disorders in infants with CKD: clinical practice points from the ESPN CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce.

Bacchetta J, Peter Schmitt C, Bakkaloglu S, Cleghorn S, Leifheit-Nestler M, Prytula A Pediatr Nephrol. 2023; 38(9):3163-3181.

PMID: 36786859 PMC: 10432337. DOI: 10.1007/s00467-022-05825-6.

Bone Disease in CKD in Children.

Santos F, Diaz-Anadon L, Ordonez F, Haffner D Calcif Tissue Int. 2021; 108(4):423-438.

PMID: 33452890 DOI: 10.1007/s00223-020-00787-z.

Phase 1, single-dose study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of etelcalcetide in pediatric patients with secondary hyperparathyroidism receiving hemodialysis.

Sohn W, Salusky I, Peter Schmitt C, Taylan C, Walle J, Ngang J Pediatr Nephrol. 2020; 36(1):133-142.

PMID: 32647975 DOI: 10.1007/s00467-020-04599-z.

Targeting optimal PD management in children: what have we learned from the IPPN registry?.

Borzych-Duzalka D, Schaefer F, Warady B Pediatr Nephrol. 2020; 36(5):1053-1063.

PMID: 32458134 PMC: 8009785. DOI: 10.1007/s00467-020-04598-0.

Bridging adults and paediatrics with secondary hyperparathyroidism receiving haemodialysis: a pharmacokinetic-pharmacodynamic analysis of cinacalcet.

Chen P, Sohn W, Narayanan A, Gisleskog P, Melhem M Br J Clin Pharmacol. 2019; 85(6):1312-1325.

PMID: 30756425 PMC: 6533487. DOI: 10.1111/bcp.13900.

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