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Renal osteodystrophy
1Department of Pediatrics, Children's Hospital of Michigan, Detroit 48201, USA.
Current Opinion in Pediatrics
|June 3, 1998
Summary
Secondary hyperparathyroidism in chronic renal failure causes bone disease in children. Treatment involves managing phosphate, calcium, and vitamin D levels to improve outcomes.
Area of Science:
- Nephrology
- Endocrinology
- Pediatrics
Background:
- Secondary hyperparathyroidism is common in chronic renal failure (CRF).
- It is histologically linked to osteitis fibrosa cystica.
- This condition causes significant growth failure and bone deformities in children.
Purpose of the Study:
- To summarize the pathogenesis and treatment of secondary hyperparathyroidism in CRF.
- To highlight its impact on pediatric bone health.
Main Methods:
- Review of the pathophysiology of renal osteodystrophy.
- Discussion of treatment strategies for secondary hyperparathyroidism in CRF.
Main Results:
- Phosphate retention, altered calcium and calcitriol metabolism are key factors.
- Metabolic acidosis, cytokines, and parathyroid hormone degradation also contribute.
- Effective treatment requires a multi-faceted approach.
Conclusions:
- Secondary hyperparathyroidism in CRF leads to severe bone disease, particularly in children.
- Management focuses on dietary phosphate restriction, phosphate binders, and vitamin D metabolites.