Hyperparathyroid bone disease in children undergoing long-term hemodialysis; treatment with vitamin D

Abstract

Or 17 children who had been in a hemodialysis program for more than six months, three had hyperparathyroid bone disease before entering the program and five developed it after two to 17 months of dialysis. The incidence of bone disease was related to the duration of azotemia and not to the duration of dialysis, to the dialysate concentration of calcium, or to the predialysis serum concentrations of urea nitrogen, calcium, and phosphorus. Six children with bone disease were treated with vitamin D in average daily doses ranging from 32,000 to 57,000 IU for periods of five to 13 months. In three the bone lesions healed, in two they were improved, and in one there was progression until a renal transplant was performed. Hypercalcemia was slight; conjunctival calcification was the only form of metastatic calcification observed. The calcium content in the skin of the children was less than that in adults who had had dialysis for comparable periods of time.