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Searching the optimal PTH target range in children undergoing peritoneal dialysis: new insights from international

Dieter Haffner1, Franz Schaefer

  • 1Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany. haffner.dieter@mh-hannover.de

Pediatric Nephrology (Berlin, Germany)
|August 16, 2012
PubMed

Insights

Optimal treatment for pediatric chronic kidney disease mineral and bone disorder (CKD-MBD) is crucial. A parathyroid hormone (PTH) range of 100-200 pg/ml is suggested for children on peritoneal dialysis.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Mineral and Bone Metabolism

Background:

  • Mineral and bone disorder (CKD-MBD) in pediatric chronic kidney disease (CKD) presents significant challenges.
  • Therapeutic goals include preventing skeletal complications, ensuring normal growth, and maintaining cardiovascular health.
  • Current pediatric guidelines for optimal parathyroid hormone (PTH) targets lack robust evidence and show considerable variation.

Purpose of the Study:

  • To review the evidence for optimal PTH target ranges in pediatric CKD patients.
  • To re-evaluate current guidelines using data from the International Pediatric Dialysis Network (IPPN) global registry.
  • To propose a reasonable PTH target range for children with CKD-MBD undergoing chronic peritoneal dialysis (PD).

Main Methods:

  • Analysis of clinical and biochemical data from the IPPN global registry, focusing on CKD-MBD in children on chronic PD.
  • Comprehensive evaluation of CKD-MBD outcome measures within this patient cohort.
  • Review of existing literature and current pediatric consensus guidelines.

Main Results:

  • The IPPN registry provides valuable data on CKD-MBD in pediatric PD patients.
  • Existing guidelines for PTH targets in pediatric CKD are based on limited evidence.
  • A PTH target range of 1.7-3 times the upper limit of normal (100-200 pg/ml) is identified as reasonable.

Conclusions:

  • The established PTH target range of 100-200 pg/ml is supported by the IPPN registry data for children on chronic PD.
  • This evidence-based range can aid in managing pediatric CKD-MBD.
  • Further research may refine targets, but this range offers a practical guideline.

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