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Titolo:
Preservation of bone mass in pediatric dialysis and transplant patients
Autore:
Alon, US;
Indirizzi:
Univ Missouri, Childrens Mercy Hosp, Sect Pediat Nephrol, Kansas City, MO 64108 USA Univ Missouri Kansas City MO USA 64108 Nephrol, Kansas City, MO 64108 USA Univ Missouri, Childrens Mercy Hosp, Bone & Mineral Disorders Clin, KansasCity, MO 64108 USA Univ Missouri Kansas City MO USA 64108 ers Clin, KansasCity, MO 64108 USA
Titolo Testata:
ADVANCES IN RENAL REPLACEMENT THERAPY
fascicolo: 3, volume: 8, anno: 2001,
pagine: 191 - 205
SICI:
1073-4449(200107)8:3<191:POBMIP>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
GROWTH-HORMONE TREATMENT; CHRONIC-RENAL-FAILURE; INTERMITTENT CALCITRIOL THERAPY; SERUM PARATHYROID-HORMONE; RECEPTOR MESSENGER-RNA; IMPERFECTA TYPE-III; SECONDARY HYPERPARATHYROIDISM; MINERAL DENSITY; KIDNEY-TRANSPLANTATION; OSTEOGENESIS-IMPERFECTA;
Keywords:
adynamic bone disease; bone biopsy; bone mineral dialysis; growth; hyperparathyroidism; renal failure; renal oateodystrophy; transplantation;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
102
Recensione:
Indirizzi per estratti:
Indirizzo: Alon, US Univ Missouri, Childrens Mercy Hosp, Sect Pediat Nephrol, 2401 Gillham Rd,Kansas City, MO 64108 USA Univ Missouri 2401 Gillham Rd Kansas City MO USA 64108 64108 USA
Citazione:
U.S. Alon, "Preservation of bone mass in pediatric dialysis and transplant patients", ADV RENAL R, 8(3), 2001, pp. 191-205

Abstract

Renal osteodystrophy continues to be a major challenge to the physician treating the child with end-stage renal disease (ESRD). The gold standard forthe assessment of bone status is bone histomorphometry, which divides bonepathology into 3 main types; high-turnover, low-turnover, and mixed disease. The high-turnover disease, related to hyperparathyroidism, has been the one most extensively investigated; however, optimal therapy, especially in the growing child, is yet unclear. Overzealous treatment might result in adynamic bone disease (an extreme example of low-turnover disease), and further interference with statural growth. Pre-existent bone disease after kidney transplantation seems to worsen immediately, probably because of the highdose of corticosteroids used. In children who attain normal kidney function in the allograft, bone status seems to improve over time. Little is knownabout bone in transplanted patients with reduced glomerular filtration rate (GFR). The correlation between bone histology and its main surrogates, bone remodeling markers and bone mineral density, is yet unclear, but it might serve to follow the progress of an individual patient. New therapeutic modalities aimed at suppressing hyperparathyroidism, and consequently bone resorption, as well as agents directly attenuating bone resorption, should befurther investigated for their effect on bone in patients with ESRD or after transplantation. Similarly, agents stimulating bone formation, particularly growth hormone, require further attention for their potential to improve bone status. Bone health and the child's somatic growth at ESRD or after kidney transplantation are closely related, and therapy should be aimed at achieving optimal results for both. (C) 2001 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 09:07:39