Diagnosis and management of mineral and bone disorders in infants with CKD: clinical practice points from the ESPN CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce

Archive ouverte

Bacchetta, Justine | Schmitt, Claus Peter | Bakkaloglu, Sevcan | Cleghorn, Shelley | Leifheit-Nestler, Maren | Prytula, Agnieszka | Ranchin, Bruno | Schön, Anne | Stabouli, Stella | van de Walle, Johan | Vidal, Enrico | Haffner, Dieter | Shroff, Rukshana

Edité par CCSD ; Springer Verlag -

International audience. Abstract Background Infants with chronic kidney disease (CKD) form a vulnerable population who are highly prone to mineral and bone disorders (MBD) including biochemical abnormalities, growth retardation, bone deformities, and fractures. We present a position paper on the diagnosis and management of CKD-MBD in infants based on available evidence and the opinion of experts from the European Society for Paediatric Nephrology (ESPN) CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce. Methods PICO (Patient, Intervention, Comparator, Outcomes) questions were generated, and relevant literature searches performed covering a population of infants below 2 years of age with CKD stages 2–5 or on dialysis. Clinical practice points (CPPs) were developed and leveled using the American Academy of Pediatrics grading matrix. A Delphi consensus approach was followed. Results We present 34 CPPs for diagnosis and management of CKD-MBD in infants, including dietary control of calcium and phosphate, and medications to prevent and treat CKD-MBD (native and active vitamin D, calcium supplementation, phosphate binders). Conclusion As there are few high-quality studies in this field, the strength of most statements is weak to moderate, and may need to be adapted to individual patient needs by the treating physician. Research recommendations to study key outcome measures in this unique population are suggested. Graphical Abstract

Consulter en ligne

Suggestions

Du même auteur

Metabolic Acidosis Is Associated With an Accelerated Decline of Allograft Function in Pediatric Kidney Transplantation

Archive ouverte | Prytula, Agnieszka | CCSD

International audience

Bone evaluation in paediatric chronic kidney disease: clinical practice points from the European Society for Paediatric Nephrology CKD-MBD and Dialysis working groups and CKD-MBD working group of the ERA-EDTA

Archive ouverte | Bakkaloglu, Sevcan | CCSD

International audience. Abstract Mineral and bone disorder (MBD) is widely prevalent in children with chronic kidney disease (CKD) and is associated with significant morbidity. CKD may cause disturbances in bone rem...

Active vitamin D is cardioprotective in experimental uraemia but not in children with CKD Stages 3–5

Archive ouverte | Schön, Anne | CCSD

International audience. Abstract Background Uraemic cardiac remodelling is associated with vitamin D and Klotho deficiency, elevated fibroblast growth factor 23 (FGF23) and activation of the renin–angiotensin system...

Chargement des enrichissements...