Abstract
Abnormalities of calcium and phosphorus metabolism and hyperparathyroidism are major problems for children with renal failure. It is hoped that dialysis will reverse these problems and prevent the progression of renal osteodystrophy.Children starting either hemodialysis(HD,n=18), intermittent peritoneal dialysis (IPD, n=16)or continuous ambulatory peritoneal dialysis(CAPD,n=12)and remaining on the same modality for 6 months were compared for serum calcium(Ca), phosphorus (P), alkaline phosphatase (A-p), parathyroid hormone(PTH)and the oral aluminum hydroxide dose (Al-d) required. All children received dihydrotachysterol or calcitriol.Children started dialysis with abnormalities in Ca and P metabolism and although serum Ca and P improved on dialysis, PTH and Al-d did not decrease. In addition, there was no significant difference in any parameters between the different dialysis modalities. Therefore, earlier and more aggressive medical treatment prior to dialysis and early transplant in children may be the best approach to normalize Ca and P metabolism, since dialysis offers little benefit.
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