PMID- 16583243
OWN - NLM
STAT- MEDLINE
DCOM- 20061114
LR  - 20181113
IS  - 0931-041X (Print)
IS  - 0931-041X (Linking)
VI  - 21
IP  - 6
DP  - 2006 Jun
TI  - Calcium and phosphate balance in adolescents on home nocturnal haemodialysis.
PG  - 835-41
AB  - Studies in adults show superior serum phosphate and parathyroid hormone (PTH) 
      control on slow nocturnal haemodialysis (NHD) compared with conventional 
      haemodialysis. We studied the progress of four children aged 12, 13, 14 and 16 
      years after they had been initiated on NHD. The follow-up period ranged from 6 
      months to 20 months. Biochemical indices of bone metabolism were collected 
      prospectively. All four children were initially dialysed against a 1.5 mmol/l 
      calcium bath. In two patients, owing to biochemical hypocalcaemic episodes, the 
      dialysate calcium concentration was increased to 1.75 mmol/l. One patient became 
      hypercalcaemic and received calcitonin for bone pain secondary to osteoporosis 
      and was dialysed against a 1.0 mmol/l calcium bath. Including an evaluation of 
      dietary intake, all four patients had a net positive calcium balance, ranging 
      from 5.1 mmol/m2 body surface area (BSA) per day to 24.3 mmol/m2 BSA per day. A 
      significant reduction in the pre-dialysis phosphate level was observed in all 
      four patients, such that none required dietary restrictions or phosphate binders, 
      and dialysate phosphate supplements of 0.8-2.03 mmol/l were employed to prevent 
      hypophosphataemia. The (CaxPO4) dropped below 4.4 mmol(2) l(-2) in all four 
      patients. Concurrently, significant reductions in intact PTH levels were seen in 
      all four patients, but the level dropped to below normal range in two. In our 
      cohort of patients, NHD rapidly lowered plasma phosphate and PTH levels, and 
      additional dialysate phosphate and possibly calcium may be necessary to prevent 
      bone demineralisation due to chronic losses and to prevent oversuppression of 
      PTH.
FAU - Hothi, Daljit K
AU  - Hothi DK
AD  - Department of Nephrology, Hospital for Sick Children, 555 University Avenue, 
      Toronto, Ontario, M5G 1X8, Canada. daljit.hothi@sickkids.ca
FAU - Harvey, Elizabeth
AU  - Harvey E
FAU - Piva, Elizabeth
AU  - Piva E
FAU - Keating, Laura
AU  - Keating L
FAU - Secker, Donna
AU  - Secker D
FAU - Geary, Denis F
AU  - Geary DF
LA  - eng
PT  - Journal Article
DEP - 20060401
PL  - Germany
TA  - Pediatr Nephrol
JT  - Pediatric nephrology (Berlin, Germany)
JID - 8708728
RN  - 0 (Biomarkers)
RN  - 0 (PTH protein, human)
RN  - 0 (Parathyroid Hormone)
RN  - 0 (Phosphates)
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Adolescent
MH  - Biomarkers/blood
MH  - Body Surface Area
MH  - Bone Density
MH  - Bone and Bones/metabolism
MH  - Calcium/*blood
MH  - Child
MH  - Female
MH  - *Hemodialysis, Home
MH  - Humans
MH  - Hyperparathyroidism, Secondary/diagnosis/*prevention & control
MH  - Hypocalcemia/*diagnosis
MH  - Male
MH  - Parathyroid Hormone/blood
MH  - Phosphates/*blood
EDAT- 2006/04/04 09:00
MHDA- 2006/11/15 09:00
CRDT- 2006/04/04 09:00
PHST- 2005/07/12 00:00 [received]
PHST- 2005/11/08 00:00 [accepted]
PHST- 2005/10/28 00:00 [revised]
PHST- 2006/04/04 09:00 [pubmed]
PHST- 2006/11/15 09:00 [medline]
PHST- 2006/04/04 09:00 [entrez]
AID - 10.1007/s00467-006-0048-z [doi]
PST - ppublish
SO  - Pediatr Nephrol. 2006 Jun;21(6):835-41. doi: 10.1007/s00467-006-0048-z. Epub 2006 
      Apr 1.