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Children with chronic kidney disease: a 3‐year prospective study of growth, bone mass and bone turnover
Author(s) -
SwolinEide Diana,
Hansson Sverker,
Magnusson Per
Publication year - 2009
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2008.01073.x
Subject(s) - medicine , bone remodeling , bone mineral , kidney disease , prospective cohort study , bone density , osteoporosis , vitamin d and neurology , bone disease , endocrinology , renal function
Aim: Children with chronic kidney disease (CKD) are at risk of developing skeletal problems. This 3‐year prospective study investigated the development of bone mass and bone turnover in children with CKD. Methods: Fifteen patients, 4–15 years, were included with a median glomerular filtration rate of 48 (range 8–94) mL/min/1.73 m 2 . Bone mineral density (BMD) and markers of bone and mineral metabolism were investigated over a 3‐year period. Results: Growth was satisfactory but a delayed bone age was observed. Total body bone mineral density (TBBMD) Z‐scores were below zero in five patients at start and after 3 years, but none had a Z‐score below −2.5. Lumbar spine BMD Z‐scores were below zero in three patients at start and in five patients after 3 years. The median TBBMD and lumbar spine Z‐scores did not change during the study period. Eleven CKD patients had increased PTH levels at baseline and 13 patients after 3 years. Most children had normal levels of leptin and vitamin D. Almost 50% of the patients had increased osteoprotegerin levels after 3 years. Conclusion: A normal BMD does not exclude mineral bone disorder in patients with CKD, yet the BMD Z‐scores were well preserved and most markers of bone turnover were within the reference intervals.