title: Prevalence of Hyperparathyroidism, Mineral and Bone Disorders in Children with Advanced Chronic Kidney Disease.
abstract: OBJECTIVE
  To identify the prevalence and risk factors for secondary hyperparathyroidism in children with advanced stages of chronic kidney disease (CKD).
  
  
  METHODS
  A retrospective cross-sectional observational study of clinical and laboratory data of pediatric patients with CKD stage 3, 4 was conducted from 2005 through 2013 at a single center in the Kingdom of Saudi Arabia.
  
  
  RESULTS
  One hundred nineteen children (60.5 % boys) with mean age of 10.1 ± 5.1 y were included in the study. The mean eGFR (estimated Glomerular Filtration Rate) was 18.3 ± 15.4 ml/min/1.73m(2) and the mean intact parathyroid hormone (iPTH) level was 62.2 ± 89.4 pmol/L. Patients with a high iPTH had lower eGFR than those who were euparathyroid (16 ± 13.4 vs. 29.7 ± 19 ml/min/1.73m(2), respectively; p = 0.006), had lower calcium levels (2.2 ± 0.3 vs. 2.4 ± 0.3 mmol/L; p = 0.03) and a lower bicarbonate level (21.2 ± 4.2 vs. 23.3 ± 3.2 mmol/L; p = 0.04). Three children with hyperparthyrodism (4.9 %) had fractures, 16 (26.2 %) had bone deformities compared to 5 in the euoparathyroid group (p = 0.012). Parathyroid hormone negatively correlated with the patient's eGFR (r = -0.55), serum calcium (r = -0.43), and positively correlated with serum phosphate (r = 0.38).
  
  
  CONCLUSIONS
  The single most important predictor of hyperparathyroidism in children in the present sample was eGFR.
authors.affiliation: Department of Pediatrics, King Abdulaziz University , PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.
authors.forename: Sherif
authors.initials: S
authors.lastname: El Desoky
authors.affiliation: Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Youssef M K
authors.initials: YM
authors.lastname: Farag
authors.affiliation: Department of Pediatrics, King Abdulaziz University , PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.
authors.forename: Eatidal
authors.initials: E
authors.lastname: Safdar
authors.affiliation: Department of Pediatrics, King Abdulaziz University , PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: Shalaby
authors.affiliation: Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Singh
authors.affiliation: Department of Pediatrics, King Abdulaziz University , PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia. jkari@doctors.org.uk.
authors.forename: Jameela A
authors.initials: JA
authors.lastname: Kari
mesh_terms: D000293:Adolescent; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D002118:Calcium / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D062072:Patient Acuity; D011237:Predictive Value of Tests; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium
keywords: CKD-MBD; Children; Hyperparathyroidism
references.citation: Am J Kidney Dis. 2009 Jun;53(6):1002-13
references.pmid: 19463763
references.citation: Ann Saudi Med. 2012 Sep-Oct;32(5):473-8
references.pmid: 22871615
references.citation: Pediatr Nephrol. 2008 Oct;23(10):1831-6
references.pmid: 18575896
references.citation: Nephrol Dial Transplant. 2012 Aug;27(8):3063-71
references.pmid: 22851629
references.citation: Semin Dial. 2004 Sep-Oct;17(5):349-50
references.pmid: 15461740
references.citation: J Am Soc Nephrol. 2002 Nov;13(11):2762-9
references.pmid: 12397047
references.citation: Kidney Int Suppl. 2005 Jun;(95):S8-12
references.pmid: 15882315
references.citation: Pediatr Nephrol. 2014 Jul;29(7):1175-9
references.pmid: 23989395
references.citation: Clin J Am Soc Nephrol. 2009 Jan;4(1):186-94
references.pmid: 19019998
references.citation: Pediatr Nephrol. 2010 Apr;25(4):769-78
references.pmid: 19898875
references.citation: Arch Pediatr. 2013 Jun;20(6):601-7
references.pmid: 23642898
references.citation: Kidney Int. 2007 Jan;71(1):31-8
references.pmid: 17091124
references.citation: Pediatr Nephrol. 2006 Feb;21(2):151-9
references.pmid: 16247644
references.citation: J Clin Endocrinol Metab. 2013 May;98(5):1930-8
references.pmid: 23547048
references.citation: J Am Soc Nephrol. 2009 Mar;20(3):629-37
references.pmid: 19158356
references.citation: Semin Nephrol. 2013 Mar;33(2):169-79
references.pmid: 23465503