Bulla M, Stock G J, Delling G, Hofmann H, Offermann G
Klin Wochenschr. 1980 Mar 3;58(5):237-47. doi: 10.1007/BF01476970.
Growth arrest and renal osteodystrophy is a major problem in renal insufficiency of children. The present report describes our experiences in managing renal osteodystrophy by using vitamin D3 for 24 months. Values in plasma of Ca, Mg, alkaline phosphatase, iPTH, 25-OH-D were determined regularly. Skeletal X-rays and analysis of iliac crest bone biopsies were obtained in each child. In treatment with vitamin D3 no hypercalcemia was seen despite high serum levels of 25-OH-D. Plasma-Ca, alkaline phosphatase, and iPTH normalized nearly. Radiographic abnormalities improved. Bone biopsies showed improvement in signs of secondary hyperparathyroidism and ostitis fibrosa, whereas osteomalacia remained unchanged. Osteoblast population showed a small reduction. No real increment in body growth was seen.
生长停滞和肾性骨营养不良是儿童肾功能不全的一个主要问题。本报告描述了我们使用维生素D3治疗肾性骨营养不良24个月的经验。定期测定血浆中钙、镁、碱性磷酸酶、甲状旁腺激素(iPTH)、25-羟基维生素D(25-OH-D)的值。对每个儿童进行骨骼X线检查和髂嵴骨活检分析。在用维生素D3治疗期间,尽管血清25-OH-D水平很高,但未出现高钙血症。血浆钙、碱性磷酸酶和iPTH几乎恢复正常。影像学异常有所改善。骨活检显示继发性甲状旁腺功能亢进和纤维性骨炎的体征有所改善,而骨软化症保持不变。成骨细胞数量略有减少。未观察到身体生长有实际增加。