Abstract
Twelve children, 2–16 years of age (mean 9.7) were dialyzed 3× weekly for periods of 7–33 months. Bone resorption typical of secondary hyperparathyroidism was present on x-ray at the onset of dialysis in 3 and developed after periods of 3–17 months in 4 more. Mean individual predialysis values were BUN 57–89 mg%, calcium 8.9–10.1 mg%, and phosphorus 4.2–7.2 mg%; there were no differences between the group means of those with bone disease and those without. The mean duration of uremia and/or dialysis was greater in the children who developed bone disease and only 1 of 7 dialyzed >1 year failed to show bone resorption. Plasma parathormone levels were elevated in all children tested (9) but were highest in those with bone disease while alkaline phosphatase levels were elevated in all with bone disease and in only one without. Six children with bone disease were treated with vitamin D, 25–75,000 U daily, for periods of 4–11 months with complete resolution in 2, marked improvement in 3, and progression of disease until transplantation in 1. Fall in parathormone and alkaline phosphatase levels accompanied radiographic improvement. Hypercalcemia occurred in 2 but metastatic calcification, other than conjunctival, was not observed and the children were asymptomatic. The frequency of bone disease in these children was similar to that reported from adult dialysis centers, but the response to vitamin D and lack of toxicity were more favorable than has been reported in adults.
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Potter, D., Roof, B., Piel, C. et al. Occurrence and treatment of secondary hyperparathyroidism in children on long-term hemodialysis. Pediatr Res 5, 384 (1971). https://doi.org/10.1203/00006450-197108000-00055
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DOI: https://doi.org/10.1203/00006450-197108000-00055