Çocuklarda renal östeodistrofi

Çocuklarda renal osteodistrofi (ROD), kalsiyum, fosfor metabolizmasında değişiklikler ile paratiroid hormonu ve D vitamini arasındaki karmaşık ilişki sonucu gelişen bir komplikasyondur. Erişkinlerden farklı olarak, böbrek yetersizliği olan çocuklarda görülen ROD, büyüme geriliği ve kalıcı kemik deformiteleri ile birlikte ileride fiziksel özürlere neden olabilir. Bu derlemede, böbrek yetersizliği olan çocuklarda ROD’de yaklaşım ve tedavi sunulmuştur.

Renal osteodystrophy in children

Childhood renal osteodystrophy (ROD) is the consequence of disturbances in calcium and phosphorus metabolism and their complex interrelationship with parathyroid hormone and vitamin D. Unlike adults, ROD in children may lead to growth failure and permanent bone deformities which may cause disabling complications. In this review, an approach to the management and treatment of ROD in children with chronic renal failure is presented.

___

  • 1. Hruska K. Pathophysiology of renal osteodystrophy. Pediatr Nephrol 2000; 14:636-40.
  • 2. Avner ED, Harmon WE, Niaudet P. Pediatric Nephrology. 5th ed. USA: Lippincott, 2004.
  • 3. Neu AM, Ho PL, McDonald RA, et al. Chronic dialysis in children and adolescents. The 2001 NAPRTCS annual report. Pediatr Nephrol 2002; 17:656-63.
  • 4. Millinler DS, Zinsmeister AR, Lieberman E, et al. Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 1990; 38:931-6.
  • 5. Norman LJ, Coleman JE, Macdonald I, Tomsett A, Watson AR. Nutrition and growth in relation to severity of renal disease in children. Pediatr Nephrol 2000; 14:833-6.
  • 6. Salusky IB, Ramirez JA, Oppenheim W, et all Biochemical markers of renal osteodystrophy in pediatric patients undergoing CAPD/CCPD. Kidney Int 1994; 45:253-8.
  • 7. National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003; 42:1-201.
  • 8. Salusky IB, Jüppner H. New PTH assays and renal osteodystrophy. Pediatr NephroJ 2004; 19:709-13.
  • 9. Malluche HH. Aluminium and bone disease in chronic renal failure. Nephrol Dial Transplant 2002: 21-4.
  • 10. Barrett IR, Papadimitriou DG. Skeletal disorders in children with renal failure. J Pediatr Orthop 1996; 16:264-72.
  • 11. Klaus G, Watson A, Edefonti A, et al. Prevention and treatment of renal osteodystrophy in children on chronic renal failure: European guidelines. Pediatr Nephrol 2006; 21:151-9.
  • 12. Bakr AM. Bone mineral density and bone turnover markers in children with chronic renal failure. Pediatr Nephrol 2004; 19:1390-3.
  • 13. Tasic V. Management of renal osteodystrophy in children. Turk J Pediatr 2005: 13-8.
  • 14. Schaefer K, Sheer J, Asmus G, et al. The treatment of uraemic hyperphosphataemia with calcium acetate and calcium carbonate: a comparative study. Nephrol Dial Transplant 1991; 6:171-5.
  • 15. Sanchez CP. Chronotherapy of high-dose active vitamin D3: is evening dosing preferable? Pediatr Nephrol 2004; 19:722-3.
  • 16. Goodman WG, Goldin J, Kuizon BD, et al. Coronary artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000; 342:1478-83.
  • 17. Slatopolsky EA, Burke SK, Dillon MA. RenaGel, a nonabsorbed calcium- and aluminum-free phosphate binder, lowers serum phosphorus and parathyroid hormone. The RenaGel Study Group. Kidney Int 1999; 55:299-307.
  • 18. Pieper AK, Haffner D, Hoppe B, et al. A randomized crossover trial comparing sevelamer with calcium acetate in children with CKD. Am J Kidney Dis 2006; 47:625-35.
  • 19. D'Haese PC, Spasovski GB, Sikole A, et al. A multicenter study on the effects of lanthanum carbonate (Fosrenol) and calcium carbonate on renal bone disease in dialysis patients. Kidney Int Suppl 2003; 85:73-8.
  • 20. Al-Baaj F, Speake M, Hutchison AJ. Control of serum phosphate by oral lanthanum carbonate in patients undergoing haemodialysis and continous ambulatory peritoneal dialysis in a short-term, placebo-controlled study. Nephrol Dial Transplant 2005; 20:775-82.
  • 21. Cunningham J. New vitamin D analogues for osteodystrophy in chronic .kidney disease. Pediatr Nephrol 2004; 19:705-8.
  • 22. Hirata M, Katsumata K, Masaki T, et al. 22-Oxacalcitriol ameliorates high-turnover bone and marked osteitis fibrosa in rats with slowly progressive nephritis. Kidney Int 1999; 56:2040-7.
  • 23. Monier-Faugere MC, Geng Z, Friedler RM, et al. 22-Oxacalcitriol suppresses secondary hyperparathyroidism without inducing low bone turnover in dogs with renal failure. Kidney Int 1999; 55:821-32.
  • 24. Akizawa T, Suzuki M, Akiba T, et al. Long-term effect of 1,25-dihydroxy-22-oxavitamin D3 on secondary hyperparathyroidism in haemodialysis patients. One-year administration study. Nephrol Dial Transplant 2002; 17:28-36.
  • 25. Coburn JW, Maung HM, Elangovan L, et al. Doxercalciferol safely suppresses PTH levels in patients with secondary hyperparathyroidism associated with chronic kidney disease stages 3 and 4. Am J Kidney Dis 2004; 43:877-90.
  • 26. Sprague SM, Lerma E, McCormmick D, et al. Suppression of parathyroid hormone secretion in hemodialysis patients: comparison of paricalcitol with calcitriol. Am J Kidney Dis 2001; 38:51-6.
Çocuk Dergisi-Cover
  • ISSN: 1302-9940
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2000
  • Yayıncı: İstanbul Üniversitesi
Sayıdaki Diğer Makaleler

Kronik monoartrit tablosuyla seyreden brusella vakası

Müferet ERGÜVEN, Atiye FEDAKAR, Osman SAÇAR, Nevin AKSU, Sevliya ÖCAL, Fatma KESKİN

Çocuklarda vazoaktif tedavide kullanılan ilaçların karşılaştırılması ve mortalite belirteçlerinin saptanması

DEMET DEMİRKOL, Metin KARABÖCÜOĞLU, Agop ÇITAK, Raif ÜÇSEL, Nedret UZEL

Akut gastroenteritli çocuklarda rotavirus ve adenovirus prevalansı

Candan ÇİÇEK, Tuba KARATAŞ, Altınay BİLGİÇ, Güldane KOTUROĞLU, Zafer KURUGÖL

Çocuklarda renal östeodistrofi

Harika ALPAY, Nihal ÖZDEMİR

Nöbet ve/veya akut ensefalopati ile başvuran hastalarda nörometabolik hastalıklar: Üç vaka sunumu

Nihal ÖZDEMİR, Canan KOCAMAN, Tolunay BAYKAL, Mustafa BERBER, Yüksel YILMAZ

Joubert sendromlu bir vaka sunumu

NÜKHET ALADAĞ ÇİFTDEMİR, Serap KARASALİHOĞLU, Ülfet VATANSEVER, Naci ÖNER, Coşkun ÇELTİK, Ercüment ÜNLÜ, Ufuk UTKU

Karbonmonoksit zehirlenmesinin geç nörolojik bulguları: Bir vaka sunumu

NİLÜFER ELDEŞ HACIFAZLIOĞLU, Gonca ÜSTÜNDAĞ, Ebru KUTSAL, Cumhur AYDEMİR, Tunç TUNÇER, Emine AMİROVA

Birinci basamaktan okullara ergen sağlık eğitimi

MEMNUNE ÇİĞDEM APAYDIN KAYA, A. Sami YAZAR, Gülçin ALDIRMAZ, Mehmet BOZOK, Pemra C. ÜNALAN

Floating-harbor sendromunda yeni bir bulgu: Lineer pigmentasyon

Abdurrahman GÜL, BAYRAM ÖZHAN, Mehmet TAŞTAN, Ali Rahmi BAKİLER

Çocuk ve adolesanlarda gerilim tipi başağrılarının tanısındaki yenilikler

Aycan ÜNALP