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Pediatric CKD-MBD: existing and emerging treatment approaches

Rose M Ayoob1, John D Mahan2

  • 1Joan C Edwards School of Medicine, Marshall University, Huntington, WV, USA.

Pediatric Nephrology (Berlin, Germany)
|January 17, 2022
PubMed

Insights

Chronic kidney disease-metabolic bone disease (CKD-MBD) involves bone and mineral metabolism issues. Emerging therapies like bisphosphonates show promise for improving bone mass in adults and children with CKD.

Area of Science:

  • Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Chronic kidney disease-metabolic bone disease (CKD-MBD) is characterized by disruptions in bone and mineral metabolism, impacting skeletal integrity and leading to calcifications.
  • Current management focuses on vitamin D, phosphate control, and specific vitamin D analogs.

Purpose of the Study:

  • To review emerging bone-promoting therapies for CKD-MBD.
  • To assess the potential of these therapies in both adult and pediatric populations with CKD.

Main Methods:

  • Review of emerging bone-promoting therapies, including bisphosphonates and denosumab.
  • Analysis of their effects on bone mass and fracture rates in adults with CKD-MBD.
  • Evaluation of their applicability and efficacy in pediatric CKD populations.

Main Results:

  • Emerging therapies like bisphosphonates and denosumab have demonstrated improved bone mass in adults with CKD-MBD.
  • These treatments have also shown potential for decreased fracture rates in adults.
  • Bisphosphonates appear effective in increasing bone mass in pediatric CKD patients with immobilization or muscle weakness.

Conclusions:

  • Emerging bone-promoting therapies offer potential benefits for managing CKD-MBD in adults and select pediatric cases.
  • Careful baseline assessment and monitoring are crucial when considering new bone therapies for children with CKD-MBD.
  • Bisphosphonates are a viable option for enhancing bone mass in pediatric CKD patients with specific conditions.

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