Abstract
Linear growth failure is a major complication of CRF unique to children and is related to renal osteodystrophy (ROD). 19 children, ages 2.8-16.4 yrs with CRF and BH of osteomalacia (OM), osteitis fibrosa (OF) or both (OFM) were given 1-2 mcg/kg/d of 25D to evaluate effects on ROD & GV. GV was defined by standard deviation scores on Tanner growth charts, the preferred method of expressing growth in pts with CRF. Group GV (mean±SEM) was -1.75±.45 in the pre-Rx year, increasing to +.2±.31 after the 1st Rx yr, and correlated with an increase in serum 25D of 42±8 ng/ml to 244±20 ng/ml (r=.37, p<.002). Pre-Rx BH showed 7 pts with OM, 9 with OFM, & 3 with OF. Pre-Rx GV was similar in the 3 groups, but increased in OM (p<.002) while remaining unchanged in OFM (p=NS) after the 1st Rx year. Data were insufficient to analyze OF pts. BH after the 1st Rx year normalized in 4/7 OM, 2/9 OFM, and 2/3 OF. GV remained unchanged (p=NS) after 1st Rx year over the subsequent 3 Rx yrs in all BH groups despite 7 pts progressing to ESRF. Changes in GV & BH did not correlate with CO2, PO4, Ca, iPTH or GFR when pre-Rx levels were compared to 1st or later Rx years. In conclusion: 25D often heals abnormal BH, especially OM; is associated with an increase in GV after 1st Rx year and its preservation in ensuing Rx years. Supported in part by The Upjohn Company.
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Langman, C., Mazur, A., Baron, R. et al. 1515 SUSTAINED IMPROVEMENT IN GROWTH VELOCITY (GV) & BONE HISTOLOGY (BH) WITH 250HD3 (250) THERAPY (RX) IN CHRONIC RENAL FAILURE (CRF). Pediatr Res 15 (Suppl 4), 695 (1981). https://doi.org/10.1203/00006450-198104001-01538
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DOI: https://doi.org/10.1203/00006450-198104001-01538