Abstract
To determine at which point in chronic renal insufficiency (CRI) the physiologic conditions for altered bone metabolism appear, radiographs, serum chemistries, parathyroid hormone (PTH), and neph cAMP were evaluated in 25 children with CRI compared to 7 children with benign renal disease and normal renal function:
Neph cAMP increases linearly with creatinine (Cr) (r=0.81) and PTH (r=0.89) except for patients on chronic hemodialysis, in whom a metabolic steady state did not exist, or for patients with serum Cr > 8.Omg/dl. Serum Cr appropriate for age and height was universally associated with neph cAMP< 4.Onmol/100mlGF, while neph cAMP was elevated in 9/15 patients with Cr > 1.Omg/dl and all patients with Cr > 3.5mg/dl. Both PTH and neph cAMP were elevated in asymptomatic patients with Cr as low as 1.45mg/dl. Neph cAMP > 4.Onmol/100mlGF is a reliable, non-invasive measure of early changes consistent with the development of renal osteodystrophy even before routine changes are evident.
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Krensky, A., Grupe, W., Harmon, W. et al. 1514 ELEVATION OF NEPHROGENOUS CYCLIC ADENOSINE MONOPHOSPHATE (Neph CAMP) AS EVIDENCE OF EARLY RENAL OSTEODYSTROPHY. Pediatr Res 15 (Suppl 4), 695 (1981). https://doi.org/10.1203/00006450-198104001-01537
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DOI: https://doi.org/10.1203/00006450-198104001-01537