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

Rees, L; Shroff, R; (2015) The demise of calcium-based phosphate binders-is this appropriate for children? Pediatric Nephrology , 30 (12) pp. 2061-2071. 10.1007/s00467-014-3017-y. Green open access

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Abstract

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.

Type: Article
Title: The demise of calcium-based phosphate binders-is this appropriate for children?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00467-014-3017-y
Publisher version: http://dx.doi.org/10.1007/s00467-014-3017-y
Language: English
Additional information: Copyright © The Author(s) 2014. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
Keywords: Chronic kidney disease, Children, Mineral bone disorder, Calcium balance, Phosphate binders, Vascular calcification, Bone mineral density
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1460193
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