Children with chronic kidney disease: a 3-year prospective study of growth, bone mass and bone turnover.
OBJECTIVE
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.


CONCLUSIONS
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.
Swolin-Eide
Diana
D
Department of Pediatrics, Institute for Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Hansson
Sverker
S
Magnusson
Per
P
D000293:Adolescent; D001846:Bone Development; D001842:Bone and Bones / Q000378:metabolism*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors