Progression of mineral metabolism derangements in childhood chronic renal failure

Bone Miner. 1986 Dec;1(6):475-83.

Abstract

2 groups of children affected by different degrees of chronic renal failure (group 1, 55-36 ml/min/1.73 m2; group 2, 35-20 ml/min/1.73 m2 of creatinine clearance) due to tubulo-interstitial disease were studied for one year. The spontaneous evolution of altered mineral metabolism at different levels of glomerular filtration rate (GFR) was aimed at. Parathyroid hormone, vitamin D metabolites and bone mineral content were evaluated. At the end of the year, only a decrease of plasma levels of 1,25(OH)2D in group 1 and a worsening of all mineral metabolism parameters in group 2 were found. The results are consistent with the hypothesis that mineral metabolism derangements progress rapidly after a certain 'threshold' of endocrinologically active renal mass is reached. The falling of plasma 1,25(OH)2D levels below a still undetermined critical value might be assumed as an index of this threshold.

MeSH terms

  • Adolescent
  • Bone and Bones / metabolism
  • Calcitriol / blood
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kidney Failure, Chronic / metabolism*
  • Male
  • Minerals / metabolism*
  • Parathyroid Hormone / blood
  • Time Factors

Substances

  • Minerals
  • Parathyroid Hormone
  • Calcitriol