Value of the new bone classification system in pediatric renal osteodystrophy.

Clinical Journal of the American Society of Nephrology : CJASN
Sevcan A BakkalogluIsidro B Salusky

Abstract

Although lesions of renal osteodystrophy have traditionally been defined by bone turnover, alterations in skeletal mineralization and volume are also prevalent and may contribute to significant morbidity in patients with chronic kidney disease (CKD). The study presented here was undertaken to compare the traditional spectrum of renal osteodystrophy defined by bone turnover to a new classification system that includes T (turnover), M (mineralization), and V (volume) and to determine the value of biochemical parameters as predictors of specific TMV lesions. Pediatric patients (n = 161) treated with peritoneal dialysis were enrolled into the study. Increased bone turnover and abnormal mineralization were prevalent (57% and 48%, respectively); bone volume was normal or increased in all subjects. Predictive algorithms for different skeletal diagnoses were established by Classification and regression tree analysis. Serum parathyroid hormone (PTH) less than 400 pg/ml in combination with alkaline phosphatase values less than 400 IU/L provided the highest correct prediction rate for patients with both normal bone turnover and normal mineralization. Levels of PTH were higher and serum calcium levels were lower in patients with defective ...Continue Reading

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Citations

Mar 31, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Claus Peter SchmittUNKNOWN European Pediatric Dialysis Working Group
Sep 20, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Russell W Chesney
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Oct 16, 2012·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Katherine Wesseling-Perry
Feb 6, 2013·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Katherine Wesseling-Perry, Isidro B Salusky
Dec 24, 2011·Journal of the American Society of Nephrology : JASN·Hartmut H MallucheDavid Pienkowski
Nov 5, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Katherine Wesseling-PerryIsidro B Salusky
Oct 16, 2015·Journal of Receptor and Signal Transduction Research·Peng HuYuan Han Qin
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