Clinical Reviews in Bone and Mineral Metabolism

, Volume 10, Issue 3, pp 219–234

Pediatric Patients with Chronic Kidney Disease-Mineral Bone Disorder

Original Paper

DOI: 10.1007/s12018-011-9112-8

Cite this article as:
Kumar, J., Furth, S.L. & Warady, B.A. Clinic Rev Bone Miner Metab (2012) 10: 219. doi:10.1007/s12018-011-9112-8
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Abstract

Chronic kidney disease-mineral bone disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism that has deleterious consequences on skeletal and cardiovascular health. Nowhere is the morbidity of this disorder more telling than in children. During childhood and adolescence, CKD-MBD may result in poor growth and skeletal deformities, while the mineral dysregulation can manifest in cardiovascular disease in early adulthood, a development that places the patients at high risk for severe morbidity and early mortality. Unfortunately, management of CKD-MBD has been less than satisfactory in children despite recent advances and is limited by the lack of evidence-based treatment guidelines. More positive are ongoing research efforts, such as the Chronic Kidney Disease in Children and the Cardiovascular Comorbidity in Children with CKD (4C) studies that are currently providing important insights which should help better elucidate the pathogenesis and progression of mineral dysregulation and its clinical impact in children. Data from these studies and others will undoubtedly also help formulate clinical trials and the generation of evidence-based therapeutic options designed to provide more effective management of CKD-MBD in the pediatric population.

Keywords

Mineral dysregulationRenal osteodystrophyPediatricChronic kidney diseaseVitamin DFGF 23Secondary hyperparathyroidismVascular calcification

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Juhi Kumar
    • 1
  • Susan L. Furth
    • 2
    • 3
  • Bradley A. Warady
    • 4
  1. 1.Department of Pediatrics and Public HealthWeill Cornell Medical CollegeNew YorkUSA
  2. 2.Department of Pediatrics and EpidemiologyUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  3. 3.Division of NephrologyThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  4. 4.Section of Pediatric NephrologyChildren’s Mercy Hospitals and Clinics, University of Missouri-Kansas City School of MedicineKansas CityUSA