| Early Skeletal and Biochemical Alterations in Pediatric Chronic Kidney Disease. | |
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MedLine Citation:
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PMID: 22052943 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background and objectivesThe relationship between parathyroid hormone, fibroblast growth factor 23 (FGF-23), and indices of bone turnover and mineralization in children with early CKD is unknown; thus, this study characterizes the features of renal osteodystrophy and their relationship to biochemical markers of mineral metabolism.Design, setting, participants, & measurementsFifty-two patients 2-21 years of age with predialysis CKD underwent tetracycline-labeled bone biopsy. Anthropomorphic measurements and biochemical values were obtained at the time of biopsy.ResultsSerum phosphorus levels were increased in 4% of patients with stage 3 CKD and 43% of those with stage 4/5 CKD. Parathyroid hormone concentrations were elevated in 36% of patients with stage 2, 71% with stage 3, and 93% with stage 4/5 CKD, whereas FGF-23 values were elevated in 81% of all patients, regardless of CKD stage. Bone turnover was normal in all patients with stage 2, but was increased in 13% with stage 3 and 29% with stage 4/5 CKD. Defective mineralization was present in 29% of patients with stage 2, 42% with stage 3, and 79% with stage 4/5 CKD. Defective skeletal mineralization was associated with lower serum calcium levels and increased parathyroid hormone concentrations.ConclusionsElevated circulating FGF-23 levels and defects in skeletal mineralization early in the course of CKD suggest that factors other than the traditional markers of mineral deficiency play a crucial role in the development of renal bone disease. |
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Authors:
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Katherine Wesseling-Perry; Renata C Pereira; Chi-Hong Tseng; Robert Elashoff; Joshua J Zaritsky; Ora Yadin; Shobha Sahney; Barbara Gales; Harald Jüppner; Isidro B Salusky |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-3 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: - ISSN: 1555-905X ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Departments of Pediatrics and. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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