Bone mass, biochemical markers and growth in children with chronic kidney disease: a 1-year prospective study.
OBJECTIVE
This study was designed to investigate bone mineral density (BMD), growth parameters and biochemical markers in children with chronic kidney disease (CKD).


METHODS
Sixteen patients, 4-18 years, with CKD were prospectively followed for 1 year. Auxological data, body composition, BMD by dual-energy X-ray absorptiometry, bone age, bone turnover markers, vitamin D, parathyroid hormone (PTH), leptin, osteoprotegerin, insulin-like growth factor-I (IGF-I) and IGF binding protein-3 were measured. A questionnaire regarding bone health and diet was also performed.


RESULTS
Delayed bone age was observed (n = 11) and the BMD Z-scores for total body were below zero in seven patients. However, total body BMD (TBBMD) increased in 12 patients. Most patients had increased osteocalcin and carboxy-terminal telopeptide of type I collagen, but normal alkaline phosphatase, type I procollagen intact amino-terminal propeptide and tartrate-resistant acid phosphatase 5b. Ten patients had increased PTH. Most children had normal levels of leptin, osteoprotegerin, IGF-I and IGFBP-3. Leptin, at baseline, correlated with differences in TBBMD over 1 year.


CONCLUSIONS
Only seven (44%) had negative Z-scores and TBBMD increased over 1 year. Bone markers at baseline did not predict the longitudinal changes in BMD.
Swolin-Eide
Diana
D
Department of Pediatrics, Institute for Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at Göteborg University, SE-416 85 Göteborg, Sweden. diana.swolin-eide@vgregion.se
Magnusson
Per
P
Hansson
Sverker
S
D000135:Acid Phosphatase / Q000097:blood; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D024042:Collagen Type I / Q000097:blood; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010455:Peptides / Q000097:blood; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000503:physiopathology*; D000071681:Tartrate-Resistant Acid Phosphatase
D015415:Biomarkers; D024042:Collagen Type I; D007527:Isoenzymes; D020738:Leptin; D010281:Parathyroid Hormone; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase