title: Defective skeletal mineralization in pediatric CKD.
abstract: Although traditional diagnosis and treatment of renal osteodystrophy focused on changes in bone turnover, current data demonstrate that abnormalities in skeletal mineralization are also prevalent in pediatric chronic kidney disease (CKD) and likely contribute to skeletal morbidities that continue to plague this population. It is now clear that alterations in osteocyte biology, manifested by changes in osteocytic protein expression, occur in early CKD before abnormalities in traditional measures of mineral metabolism are apparent and may contribute to defective skeletal mineralization. Current treatment paradigms advocate the use of 1,25(OH)2vitamin D for the control of secondary hyperparathyroidism; however, these agents fail to correct defective skeletal mineralization and may exacerbate already altered osteocyte biology. Further studies are critically needed to identify the initial trigger for abnormalities of skeletal mineralization as well as the potential effects that current therapeutic options may have on osteocyte biology and bone mineralization.
authors: Pediatric Nephrology, David Geffen School of Medicine at UCLA, A2-383 MDCC, 650 Charles Young Dr, Los Angeles, CA, 93001-1835, USA, KWesseling@mednet.ucla.edu.
authors: Katherine
authors: K
authors: Wesseling-Perry
mesh_terms: D000293:Adolescent; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D002113:Calcification, Physiologic / Q000187:drug effects / Q000502:physiology*; D057966:Calcimimetic Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D013006:Growth Hormone / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D010011:Osteocytes / Q000378:metabolism / Q000473:pathology; D010012:Osteogenesis / Q000187:drug effects; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology*; D012279:Rickets / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D000069603:Sevelamer / Q000494:pharmacology / Q000627:therapeutic use; D014807:Vitamin D / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D057966:Calcimimetic Agents; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; D013006:Growth Hormone; D000069603:Sevelamer
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