CIN '2007 - 4º CONGRESO DE NEFROLOGIA EN INTERNET
Bone Growth in Low Bone Turnover
Cheryl P. Sanchez, MD, FAAP, FASN - Associate Professor of Pediatrics
Univ Wisc Sch Medicine & Public Health - Madison
Abstract
A dynamic bone may occur as a result of aggressive treatment of secondary hyperparathyroidism in children with chronic renal failure. In animals with renal failure and elevated PTH levels, bone growth was shorter during calcitriol administration, exogenous calcium loading and thyroparathyroidectomy. Although calcitriol and exogenous calcium both increased serum calcium and lowered PTH levels, the effects on the growth plate cartilage are quite divergent. Calcitriol decreased chondrocyte proliferation whereas, calcium loading affected all layers of the growth plate. It is important to recognize the negative effects of calcitriol, high calcium and thyroparathyroidectomy on endochondral bone growth in renal failure since these therapeutic interventions are used concurrently in the treatment of secondary hyperparathyroidism and hyperphosphatemia in growing children.Comentarios :