Abstract: FR-PO525

CKD-MBD and the Use of Immunosuppressant in KNOW-pedCKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Lee, Joo Hoon, Asan Medical Center, Seoul, Korea (the Republic of)
  • Ha, IL-Soo, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Kang, Hee Gyung, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Park, Eujin, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Ahn, Yo Han, Hallym University Kangnam Sacred Heart Hospital, Seoul, SEOUL, Korea (the Republic of)
  • Kim, Seong heon, Pusan National University Children's Hospital, Yangsan, Korea (the Republic of)
  • Han, Kyoung Hee, Jeju National University School of Medicine, Jeju, Korea (the Republic of)
  • Choi, Hyun Jin, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Cho, Min Hyun, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Park, Young seo, Asan Medical Center, Seoul, Korea (the Republic of)
Background

CKD-MBD is abnormalities in mineral metabolism and bone structure in patients with chronic kidney disease (CKD). Many children with glomerulonephritis progress to CKD. In many patients with primary or secondary glomerulonephritis, the use of immunosuppresant may cause osteroporosis and growth retardation. We evaluated the effect of immunosuppresant on CKD-MBD in children.

Methods

KNOW-pedCKD is a Korean cohort study for outcomes in patients with pediatric CKD for 10 years which started from April 2011. 458 patients with CKD stage I to V below 20 years old were included. We divided the patients into 3 groups according to CKD stage: CKD stage I-II, III, IV-V. We compared calcium, phosphorus, alkaline phosphatase (ALP), intact parathyroid horome (PTH), vitamin D, FGF-23 and transtubular reabsorption of phosphorus (TRP) between patients who had immunosuppresants (IS group) and those without drug treatment (non-IS group) in each CKD group.

Results

In IS gruop, serum calcium level was lower in CKD stage I-II (10.18 vs 10.92 mg/dL, p=0.048), III (9.99 vs 10.87, p=0.001), IV-V group (9.45 vs 10.97, p=0.001), serum phosphorus level was higher in CKD stage I-II (4.93 vs 4.57, p=0.017), serum ALP was lower in CKD stage III (135 vs 262, p<0.001), IV-V (173 vs 265, p=0.017), serum calcidiol level was lower in CKD stage I-II (17.84 vs 22.43 mg/dL, p=0.003), III (15.68 vs 24.23, p=0.002), IV-V group (11.15 vs 23.02, p<0.001), serum calcitriol level and TRP was lower in CKD stage IV-V than non-IS group. Serum intact PTH and FGF-23 level did not show difference between IS and non-IS group.

Conclusion

The use of immunosuppressant in pediatric CKD patients may worsen CKD-MBD which was associated with hypocalcemia, hyperphosphatemia and vitamin D deficiency.

Funding

  • Government Support - Non-U.S.