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Calcium and parathyroid disorders in children. Chronic renal failure and treatment with calcitriol
Insights
In children with worsening kidney failure, parathyroid hormone (PTH) levels rose significantly. Treatment with calcitriol or kidney transplant reversed these complications.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Renal Medicine
Background:
- Chronic kidney disease (CKD) in children often leads to secondary hyperparathyroidism.
- Elevated parathyroid hormone (PTH) is a common complication in pediatric renal failure.
- Monitoring PTH is crucial for managing CKD complications.
Purpose of the Study:
- To investigate the relationship between renal failure progression and parathyroid hormone (PTH) levels in children.
- To assess the impact of hemodialysis on PTH concentrations.
- To evaluate the efficacy of calcitriol and kidney transplantation in reversing renal failure complications.
Main Methods:
- Correlational analysis of serum creatinine and serum parathyroid hormone (PTH) in 23 children.
- Monitoring of biochemical parameters at six-month intervals.
- Assessment of treatment outcomes following kidney transplantation and calcitriol administration.
Main Results:
- A significant linear correlation was observed between rising serum creatinine and elevated serum PTH.
- Children on maintenance hemodialysis showed elevated PTH levels despite normal serum calcium.
- All tested variables showed progressive deterioration over time.
- Complications were reversible with kidney transplantation or calcitriol treatment.
Conclusions:
- Progressive renal failure in children is strongly associated with increasing parathyroid hormone (PTH) levels.
- Hemodialysis alone does not normalize PTH in pediatric patients.
- Calcitriol therapy and kidney transplantation offer effective treatment options for managing these complications.
Abstract:
Progression of renal failure, represented by rising serum creatinine concentrations, was correlated with progressive elevation of serum parathyroid hormone (PTH) concentrations in 23 children. A significant linear relationship was established. Despite normal serum calcium concentrations in 11 children receiving maintenance hemodialysis, circulating PTH concentrations were elevated after six months. Progressive deterioration with time occurred in all variables tested, at six-month intervals. These complications were reversible with kidney transplantation or treatment with 0.25 to 2 microgram/day of calcitriol for four to 20 weeks.