The demise of calcium-based phosphate binders—is this appropriate for children?

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• 作者：Lesley Rees ; Rukshana Shroff
• 关键词：Chronic kidney disease ; Children ; Mineral bone disorder ; Calcium balance ; Phosphate binders ; Vascular calcification ; Bone mineral density
• 刊名：Pediatric Nephrology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：30
• 期：12
• 页码：2061-2071
• 全文大小：659 KB
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  22.Cancela AL, Oliveira R
• 作者单位：Lesley Rees (1)
  Rukshana Shroff (1)
  
  1. Paediatric Nephrology, Great Ormond Street Hospital for Children, Great Ormond St, London, WC1N 3JH, UK
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Pediatrics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-198X

文摘

In children with chronic kidney disease (CKD) optimal control of mineral and bone disorder (MBD) is essential not only for the prevention of debilitating skeletal complications and for achieving adequate growth, but also for preserving long-term cardiovascular health. The growing skeleton is particularly vulnerable to the effects of CKD, and bone pain, fractures and deformities are common in children on dialysis. Defective bone mineralisation has been linked with ectopic calcification, which in turn leads to significant morbidity and mortality. Despite national and international guidelines for the management of CKD-MBD, the management of mineral dysregulation in CKD can be extremely challenging, and a significant proportion of patients have calcium, phosphate or parathyroid hormone levels outside the normal ranges. Clinical and experimental studies have shown that, in the setting of CKD, low serum calcium levels are associated with poor bone mineralisation, whereas high serum calcium levels can lead to arterial calcification, even in children. The role of calcium in CKD-MBD is the focus of this review. Keywords Chronic kidney disease Children Mineral bone disorder Calcium balance Phosphate binders Vascular calcification Bone mineral density