Summary
Chronic kidney disease (CKD) mineral bone disorder has long-term effects on skeletal
integrity and growth. Abnormalities in serum markers of mineral metabolism are evident
early in pediatric CKD. Bone deformities, poor linear growth, and high rates of fractures
are common in children with CKD. Newer imaging modalities such as high-resolution
peripheral quantitative computed tomography shows promise in assessing bone mineral
density more comprehensively and predicting incident fractures. A lack of large-scale
studies that provide a comprehensive assessment of bone histology and correlations
with serum biomarkers has contributed to the absence of evidence-based guidelines
and suboptimal management of CKD mineral bone disorder in children with CKD.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Seminars in NephrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Heart rate and blood pressure variability in children with chronic kidney disease: a report from the CKiD study.Pediatr Nephrol. 2014; 29: 1059-1065
- Carotid intima-media thickness in children with CKD: results from the CKiD study.Clin J Am Soc Nephrol. 2012; 7: 1930-1937
- Insights from the Chronic Kidney Disease in Children (CKiD) study.Clin J Am Soc Nephrol. 2011; 6: 2047-2053
- Progression of pediatric CKD of nonglomerular origin in the CKiD cohort.Clin J Am Soc Nephrol. 2015; 10: 571-577
- Academic achievement in children with chronic kidney disease: a report from the CKiD cohort.Pediatr Nephrol. 2019; 34: 689-696
- Associations between weight loss, kidney function decline, and risk of ESRD in the Chronic Kidney Disease in Children (CKiD) cohort study.Am J Kidney Dis. 2018; 71: 648-656
- CKiD (CKD in children) prospective cohort study: a review of current findings.Am J Kidney Dis. 2012; 60: 1002-1011
- Association between chronic kidney disease-mineral bone disease (CKD-MBD) and cognition in children: Chronic Kidney Disease in Children (CKiD) study.Kidney Med. 2020; 2: 398-406
- Dyslipidemia in children with chronic kidney disease.Kidney Int. 2010; 78: 1154-1163
- Blood pressure in children with chronic kidney disease: lessons learned from the Chronic Kidney Disease in Children cohort study.Pediatr Nephrol. 2020; 35: 1203-1209
- KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD–MBD).Kidney Int. 2009; 76: S1-S130
- Disordered FGF23 and mineral metabolism in children with CKD.Clin J Am Soc Nephrol. 2014; 9: 344-353
- Fibroblast growth factor 23 and phosphate homeostasis.Curr Opin Nephrol Hypertens. 2019; 28: 465-473
- Renal control of calcium, phosphate, and magnesium homeostasis.Clin J Am Soc Nephrol. 2015; 10: 1257-1272
- Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease.Kidney Int. 2011; 79: 1370-1378
- Possible involvement of circulating fibroblast growth factor 23 in the development of secondary hyperparathyroidism associated with renal insufficiency.Am J Kidney Dis. 2004; 44: 250-256
- Inflammation and functional iron deficiency regulate fibroblast growth factor 23 production.Kidney Int. 2016; 89: 135-146
- Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease.Kidney Int. 2007; 71: 31-38
- Prevalence and correlates of 25-hydroxyvitamin D deficiency in the Chronic Kidney Disease in Children (CKiD) cohort.Pediatr Nephrol. 2016; 31: 121-129
- Vitamin D deficiency is common in children and adolescents with chronic kidney disease.Kidney Int. 2012; 81: 690-697
- Race and ethnicity predict bone markers and fracture in pediatric patients with chronic kidney disease.J Bone Miner Res. 2021; 36: 298-304
- The effect of 1,25 dihydroxycholecalciferol on parathyroid hormone secretion by monolayer cultures of bovine parathyroid cells.Calcif Tissue Int. 1986; 38: 27-32
- Parathyroid hormone suppression by intravenous 1,25-dihydroxyvitamin D. A role for increased sensitivity to calcium.J Clin Invest. 1989; 83: 1349-1355
- Slatopolsky E. 1,25-dihydroxyvitamin D3 and 22-oxacalcitriol prevent the decrease in vitamin D receptor content in the parathyroid glands of uremic rats.Kidney Int. 1996; 50: 34-39
- Effect of 1,25-dihydroxyvitamin D3 on phospholipid metabolism in cultured bovine parathyroid cells.Endocrinology. 1988; 122: 2387-2392
- Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO).Kidney Int. 2006; 69: 1945-1953
- Early skeletal and biochemical alterations in pediatric chronic kidney disease.Clin J Am Soc Nephrol. 2012; 7: 146-152
- Value of the new bone classification system in pediatric renal osteodystrophy.Clin J Am Soc Nephrol. 2010; 5: 1860-1866
- What parathyroid hormone levels should we aim for in children with stage 5 chronic kidney disease; what is the evidence?.Pediatr Nephrol. 2008; 23: 179-184
- K/DOQI Clinical Practice Guidelines for bone metabolism and disease in children with chronic kidney disease.Am J Kidney Dis. 2005; 46: S6-S121
- Bone evaluation in paediatric chronic kidney disease: clinical practice points from the European Society for Paediatric Nephrology CKD-MBD and dialysis working groups and CKD-MBD working group of the ERA-EDTA.Nephrol Dial Transplant. 2021; 36: 413-425
- KDIGO 2017 Clinical Practice Guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD-MBD).Kidney Int Suppl (2011). 2017; 7: 1-59
- Limitations of dual x-ray absorptiometry in children with chronic kidney disease.Pediatr Nephrol. 2010; 25: 3-5
- Height adjustment in assessing dual energy x-ray absorptiometry measurements of bone mass and density in children.J Clin Endocrinol Metab. 2010; 95: 1265-1273
- Assessment of dual-energy X-ray absorptiometry measures of bone health in pediatric chronic kidney disease.Pediatr Nephrol. 2012; 27: 1139-1148
- Volumetric bone mineral density and bone structure in childhood chronic kidney disease.J Bone Miner Res. 2011; 26: 2235-2244
- Mineral metabolism and cortical volumetric bone mineral density in childhood chronic kidney disease.J Clin Endocrinol Metab. 2013; 98: 1930-1938
- In vivo assessment of bone structure and estimated bone strength by first- and second-generation HR-pQCT.Osteoporos Int. 2016; 27: 2955-2966
- The interplay between bone and vessels in pediatric CKD: lessons from a single-center study.Pediatr Nephrol. 2018; 33 (1565-75)
- Quantitative high-resolution magnetic resonance imaging reveals structural implications of renal osteodystrophy on trabecular and cortical bone.J Magn Reson Imaging. 2004; 20: 83-89
- The bone and mineral disorder of children undergoing chronic peritoneal dialysis.Kidney Int. 2010; 78: 1295-1304
- Fracture burden and risk factors in childhood CKD: results from the CKiD cohort study.J Am Soc Nephrol. 2016; 27: 543-550
- Epidemiology of childhood fractures in Britain: a study using the general practice research database.J Bone Miner Res. 2004; 19: 1976-1981
- Incidence and risk factors for hip or other bone fractures among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study.Kidney Int. 2006; 70: 1358-1366
- Effect of growth hormone treatment on the adult height of children with chronic renal failure. German Study Group for Growth Hormone Treatment in Chronic Renal Failure.N Engl J Med. 2000; 343: 923-930
- Mineral metabolism in European children living with a renal transplant: a European society for paediatric nephrology/European renal association-European dialysis and transplant association registry study.Clin J Am Soc Nephrol. 2015; 10: 767-775
- Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children study.Pediatr Nephrol. 2014; 29: 1987-1995
Article info
Footnotes
Financial support: Juhi Kumar is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD009115).
Conflict of interest statement: none.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
