Kidney Week

Abstract: SA-PO908

Effects of Primary Kidney Disease on Bone Histomorphometry in Pediatric Dialysis Patients

Session Information

• Mineral Disease: CKD-Bone
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

• 1203 Mineral Disease: CKD-Bone

Authors

• Sirimongkolchaiyakul, Ornatcha, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Ornatcha Sirimongkolchaiyakul,

• Wesseling-Perry, Katherine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Katherine Wesseling-Perry,

• Gales, Barbara, None, Calabasas, California, United States

Barbara Gales,

• Chow, Georgina, UCLA, Murrieta, Alabama, United States

Georgina Chow,

• Pereira, Renata C., University of California, Los Angeles, California, United States

Renata C. Pereira,

• Salusky, Isidro B., Mattel Children's Hospital, Los Angeles, California, United States

Isidro B. Salusky,

Background

Little is known as to the effect of primary kidney disease on renal osteodystrophy. The current study was thus designed to assess the association between CKD etiology, mineral metabolism and bone histromorphometry in pediatric ESKD.

Methods

Demographic, biochemical and bone histomorphometric data were analyzed from 207 patients (aged 12.7 ± 5.6 years) with ESKD who underwent double tetracycline labeled bone biopsy at UCLA. Patients were divided into 2 groups according to CKD etiology: inflammatory (n = 85) v. non-inflammatory (n=122) disease. Non-inflammatory disease was further divided into CAKUT (n = 87) v. non-CAKUT (n = 35). Serum Ca, P, ALP, PTH, 25D, and C-term FGF23 levels were measured at the time of biopsy.

Results

Serum Ca, P, PTH and 25D did not differ between groups. Serum ALP levels were higher, and cFGF23 levels were lower, in patients with CAKUT (Table). Bone turnover and volume did not differ between groups. Osteoid volume (OV/BV), osteoid surface (OS/BS), osteoid thickness (O.Th) and osteoid maturation time (OMT) were increased in patients with CAKUT. As previously reported, multiple regression analysis demonstrated that Ca, P, ALP and PTH were independent predictors of OV/BV and O.Th. ALP and PTH were an independent factors affecting BFR/BS. Disease etiology was not an independent predictor of any histomorphometric variable.

Conclusion

After controlling for biochemical variables, ESKD etiology did not affect bone histomorphometric parameters of turnover, mineralization, or volume.

Funding

• NIDDK Support