Cortical and trabecular bone in pediatric end-stage kidney disease.

Pediatric nephrology (Berlin, Germany) (2014-09-05)
Catarina G Carvalho, Renata C Pereira, Barbara Gales, Isidro B Salusky, Katherine Wesseling-Perry
ABSTRACT

Cortical bone represents nearly 80 % of human bone mass and is the major determinant of bone strength; however, cortical bone parameters and their relationship to trabecular bone in the pediatric chronic kidney disease (CKD) population have not been evaluated. Biochemical values and cortical and trabecular bone parameters were assessed in 22 pediatric dialysis patients: 12 with high and 10 with normal to low trabecular bone turnover. Trabecular bone turnover and osteoid volume correlated with parathyroid hormone (PTH) levels (r = 0.86, p < 0.01 and r = 0.93, p < 0.01, respectively). Internal cortical osteonal bone formation rate was directly related to alkaline phosphatase (r = 0.45, p < 0.05) and inversely related to insulin-like growth factor (IGF)-1 values (r = -0.55, p < 0.01), and internal cortical porosity was also related to serum alkaline phosphatase levels (r = 0.57, p < 0.01). A similar relationship was not found between external cortical bone formation rate and parameters of bone turnover and porosity, however. No relationship was found between trabecular and cortical bone formation rates. Secondary hyperparathyroidism was associated with increased external cortical, relative to internal cortical, osteonal activity in pediatric dialysis patients. The clinical consequences of these changes and their response to therapy for secondary hyperparathyroidism remain to be defined.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Calcium carbonate, ACS reagent, ≥99.0%, powder
Sigma-Aldrich
Calcium carbonate, ACS reagent, chelometric standard, 99.95-100.05% dry basis
Sigma-Aldrich
Calcium carbonate, ReagentPlus®
Sigma-Aldrich
Calcium carbonate, powder, ≤50 μm particle size, 98%
Sigma-Aldrich
Calcium carbonate, BioXtra, ≥99.0%
Supelco
Calcium carbonate, Pharmaceutical Secondary Standard; Certified Reference Material
Supelco
Calcium carbonate, certified reference material for titrimetry, certified by BAM, ≥99.5%
Sigma-Aldrich
Calcium carbonate, BioUltra, precipitated, ≥99.0% (KT)
Sigma-Aldrich
Calcium carbonate, puriss., meets analytical specification of Ph. Eur., BP, USP, FCC, E170, precipitated, 98.5-100.5% (based on anhydrous substance)
USP
Calcium Carbonate (AS), United States Pharmacopeia (USP) Reference Standard
Sigma-Aldrich
Calcium carbonate, ≥99.995% trace metals basis
Sigma-Aldrich
Calcium carbonate, 99.999% trace metals basis
Sigma-Aldrich
Calcium carbonate, tested according to Ph. Eur.
Sigma-Aldrich
Calcium carbonate, BioReagent, suitable for insect cell culture, ≥99.0%
Sigma-Aldrich
Calcium carbonate, anhydrous, free-flowing, Redi-Dri, ReagentPlus®, ≥99%