Klaus G, Watson A, Edefonti A, Fischbach M, Rönnholm K, Schaefer F, Simkova E, Stefanidis C J, Strazdins V, Vande Walle J, Schröder C, Zurowska A, Ekim M
Pediatr Nephrol. 2006 Feb;21(2):151-9. doi: 10.1007/s00467-005-2082-7. Epub 2005 Oct 25.
Childhood renal osteodystrophy (ROD) is the consequence of disturbances of the calcium-regulating hormones vitamin D and parathyroid hormone (PTH) as well as of the somatotroph hormone axis associated with local modulation of bone and growth cartilage function. The resulting growth retardation and the potentially rapid onset of ROD in children are different from ROD in adults. The biochemical changes of ROD as well as its prevention and treatment affect calcium and phosphorus homeostasis and are directly associated with the development of cardiovascular disease in pediatric renal patients. The aims of the clinical and biochemical surveillance of pediatric patients with CRF or on dialysis are prevention of hyperphosphatemia, avoidance of hypercalcemia and keeping the calcium phosphorus product below 5 mmol(2)/l(2). The PTH levels should be within the normal range in chronic renal failure (CRF) and up to 2-3 times the upper limit of normal levels in dialysed children. Prevention of ROD is expected to result in improved growth and less vascular calcification.
儿童肾性骨营养不良（ROD）是钙调节激素维生素D和甲状旁腺激素（PTH）紊乱以及生长激素轴紊乱的结果，这些紊乱与骨骼和生长软骨功能的局部调节有关。儿童由此导致的生长发育迟缓以及ROD可能的快速发病与成人ROD不同。ROD的生化变化及其预防和治疗会影响钙和磷的稳态，并且与儿科肾病患者心血管疾病的发生直接相关。对患有慢性肾衰竭（CRF）或接受透析的儿科患者进行临床和生化监测的目的是预防高磷血症、避免高钙血症并使钙磷乘积低于5 mmol²/L²。在慢性肾衰竭（CRF）患者中，甲状旁腺激素（PTH）水平应在正常范围内，而在接受透析的儿童中，PTH水平应高达正常水平上限的2至3倍。预防ROD有望促进生长并减少血管钙化。
