2007/11/27 by Katherine Wesseling, Sevcan A. Bakkaloğlu, Isidro B. Salusky · 1 citation
Medicine · Nursing · #Parathyroid Disorders and Treatments #Magnesium in Health and Disease #Pharmacological Effects and Toxicity Studies #Medicine #Hyperphosphatemia #Secondary hyperparathyroidism #Renal osteodystrophy #Internal medicine #Endocrinology #Bone remodeling #Parathyroid hormone #Kidney disease #Vitamin D and neurology #Hyperparathyroidism #Calcium metabolism #Nephrology #Calcium #Bone disease #Osteodystrophy #Osteoporosis
paper · pdf · doi:10.1007/s00467-007-0671-3
openalex publication_date 2007/11/27 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31
Childhood and adolescence are crucial times for the development of a healthy skeletal and cardiovascular system. Disordered mineral and bone metabolism accompany chronic kidney disease (CKD) and present significant obstacles to optimal bone strength, final adult height, and cardiovascular health. Decreased activity of renal 1 alpha hydroxylase results in decreased intestinal calcium absorption, increased serum parathyroid hormone levels, and high-turnover renal osteodystrophy, with subsequent growth failure. Simultaneously, phosphorus retention exacerbates secondary hyperparathyroidism, and elevated levels contribute to cardiovascular disease. Treatment of hyperphosphatemia and secondary hyperparathyroidism improves growth and high-turnover bone disease. However, target ranges for serum calcium, phosphorus, and parathyroid hormone (PTH) levels vary according to stage of CKD. Since over-treatment may result in adynamic bone disease, growth failure, hypercalcemia, and progression of cardiovascular calcifications, therapy must be carefully adjusted to maintain optimal serum biochemical parameters according to stage of CKD. Newer therapeutic agents, including calcium-free phosphate binding agents and new vitamin D analogues, effectively suppress serum PTH levels while limiting intestinal calcium absorption and may provide future therapeutic alternatives for children with CKD.