Abstract: FR-PO293

Demographic Predictors of Mineral and Bone Disorders in the Pediatric Dialysis Population

Session Information

Category: Mineral Disease

  • 1202 Mineral Disease: Vitamin D, PTH, FGF-23

Authors

  • Laster, Marciana, UCLA, Los Angeles , California, United States
  • Soohoo, Melissa, UCI, Orange, California, United States
  • Streja, Elani, UCI, Orange, California, United States
  • Norris, Keith C., UCLA, Los Angeles , California, United States
  • Salusky, Isidro B., UCLA, Los Angeles , California, United States
  • Kalantar-Zadeh, Kamyar, UCI, Orange, California, United States
Background

Secondary Hyperparathyroidism in pediatric patients on dialysis results in bone and cardiovascular abnormalities that have major implications on morbidity and mortality in both childhood and adulthood. Therefore, it is important to understand the factors which contribute to and predict perturbations in the markers of mineral and bone disorders (MBD).

Methods

In a sample of 661 children with ESRD we explored predictors of abnormalities in Calcium (Ca), Phosphorous (P04), Alkaline Phosphatase (ALP) and Parathyroid Hormone (PTH) levels within the first 3 months of dialysis using linear regression models adjusted for age, sex, race and ethnicity, disease type, Ca, P04, AP, and medication use.

Results

The cohort characteristics are displayed in Table 1. Using age-adjusted norms and KDIGO-defined goals of PTH values 2-9 times the upper limit of normal, we found that Ca, ALP and PTH were most frequently within goal ranges, while P04 was most frequently above goal (Figure 1). Significant predictors of these markers included age which predicted higher PTH, lower ALP and lower Ca; Female gender which predicted lower P04 and lower ALP; Black race which predicted higher PTH, lower P04 and lower ALP and Hispanic ethnicity which predicted higher PTH and lower Ca and P04 (Table 2).

Conclusion

Non-modifiable demographic factors associate with the markers of MBD. In particular, Black and Hispanic children have higher PTH levels and, in addition, Black children have lower AP levels. While optimization of CKD-MBD management requires consideration of these observed differences, further studies are needed to assess potential racial/ethnic differences in PTH targets in children on dialysis.

Funding

  • NIDDK Support