Disturbances of calcium-phosphate metabolism are one of the most prominent complications of chronic kidney disease with high impact on cardiovascular complications and outcome. The aim of the study was to assess the clinical efficacy of CKD-related calcium-phosphate homeostasis treatment in children and adolescents on chronic dialysis in a tertiary reference centre between 1991 to 2008.
Material and methods: Study group consisted of 81 subjects (29F, 52M): 40 hemodialysis and 41 peritoneal dialysis patients (aged at start of dialysis: 1m.-17 y.). Treatment period ranged from 7 to 150 months. 9 subjects died on dialysis. A retrospective analysis of medical records was performed for serum calcium, phosphate, parthormon, alkaline phosphatase, CaxP product and applied treatment (conservative or surgery). The analysis was conducted in 4-5 y time intervals.
Results: We did not observed significant differences in the most of analyzed parameters apart a tendency to increase in PTH levels in last 9 years. Conservative treatment comprised a diet, calcium phosphate binders, vitamin D metabolites and non-calcium phosphate binders (since 2003). Parathyroidectomy was performer as surgery.
Conclusions: The efficacy of treatment of CKD-related calcium-phosphate disturbances in children and adolescents on chronic dialysis has not changed in last several years despite introduction of new methods of treatment.