title: [Relationship between glomerular filtration rate, uric acid, and parathyroid hormone in children].
abstract: BACKGROUND
  Parathyroid hormone (PTH) and uric acid (UA) levels increase early during chronic kidney disease (CKD). The objective of this study was to evaluate the relationship between these two parameters at different stages of pediatric CKD.
  
  
  METHODS
  One hundred patients (range, 5-18 years) were included in this retrospective study: they had undergone renal exploration with a direct measurement of the glomerular filtration rate (GFR) using the reference standard (i.e., inulin clearance, Cin) and presented with increased circulating levels of PTH and/or UA.
  
  
  RESULTS
  GFR was normal in 39% of patients, with UA increased in 44% and PTH in 75% of them. Interestingly, 29% of the children with increased PTH levels had a strictly normal GFR (i.e., above 90 mL/min/1.73 m(2)). An inverse association was found between UA and GFR (r=-0.452, P ≤ 0.0001) as well as between PTH and GFR (r=-0.226, P=0.024). The same negative relationships were found between UA and PTH (r=-0.266, P=0.007), and between UA and the phosphate reabsorption rate (r=-0.415, P<0.001).
  
  
  CONCLUSIONS
  Since hyperuricemia was found at all stages of CKD, an early silent tubular impairment can be discussed to explain these findings. The early increase in PTH levels during CKD has not been described by all authors, with North American studies describing rather late increased PTH levels during CKD. Prospective studies are required to confirm these data and evaluate the role of UA in the pathophysiology of the mineral disorders observed during CKD.
authors: Service de néphrologie et d'hémodialyse, CHU du Point-G, Bamako, Mali. ddiallo2006@yahoo.fr
authors: D
authors: D
authors: Diallo
authors: L
authors: L
authors: Dubourg
authors: B
authors: B
authors: Ranchin
authors: P
authors: P
authors: Cochat
authors: J
authors: J
authors: Bacchetta
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000652:urine; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002118:Calcium / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007444:Inulin / Q000097:blood / Q000652:urine; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood*; D010758:Phosphorus / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D012189:Retrospective Studies; D014527:Uric Acid / Q000097:blood*
chemical_list: D010281:Parathyroid Hormone; D014527:Uric Acid; D010758:Phosphorus; D007444:Inulin; D003404:Creatinine; D002118:Calcium