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Calcium and Parathyroid Disorders in Children: Title and subTitle BreakChronic Renal Failure and Treatment With Calcitriol FREE

James C. M. Chan, MD; Hector R. DeLuca, PhD
[+] Author Affiliations

Reprint requests to Box 822, MCV Station, Richmond, VA 23298 (Dr Chan).


JAMA. 1979;241(12):1242-1244. doi:10.1001/jama.1979.03290380018018
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Progression of renal failure, represented by rising serum creatinine concentrations, was correlated with progressive elevation of serum parathyroid hormone (PTH) concentrations in 23 children. A significant linear relationship was established. Despite normal serum calcium concentrations in 11 children receiving maintenance hemodialysis, circulating PTH concentrations were elevated after six months. Progressive deterioration with time occurred in all variables tested, at six-month intervals. These complications were reversible with kidney transplantation or treatment with 0.25 to 2 μg/day of calcitriol for four to 20 weeks.

(JAMA 241:1242-1244, 1979)

REFERENCES

Roof BS, Gordon GS, Goldman L, et al:  Berson and Yalow's radio immunoassay for parathyroid hormone PTH: A clinical progress report . Mt Sinai J Med NY 40:433-447, 1973;.
Balsan S, Garabedian M, Sogniard R, et al:  1,25-dihydroxyvitamin D3 and 1-alpha-hydroxyvitamin D3 in children: Biologic and therapeutic effects in nutritional rickets and different types of vitamin D resistance . Pediatr Res 9:586-593, 1975;.
Brickman AS, Coburn JW, Massry SG, et al:  1,25-dihydroxyvitamin D, in normal man and in patients with renal failure . Ann Intern Med 80:161-168, 1974;.
Chan JCM, Oldham SB, Holick MF, et al:  1-α-hydroxyvitamin D3 in chronic renal failure: A potent analogue of the kidney hormone, 1,25-dihydroxycholecalciferol . JAMA 234:47-52, 1975;.
Chan JCM, Oldham SB, DeLuca HF:  Effectiveness of 1-alpha-hydroxyvitamin D3 in children with renal osteodystrophy associated with hemodialysis . J Pediatr 90:820-824, 1977;.
Wang M, Rao DD, Mauger I, et al:  Nutritional aspects of children on hemodialysis or following renal transplantation , in Chan JCM (ed): Symposium on Kidney Failure: Dialysis and Transplantation in Childhood. Clin Proc Child Hosp Natl Med Center 30:259-264, 1974;.
Chan JCM:  The effect of milk formulae on acid-balance . Nutr Metab 16:140-154, 1974;.
Mitch WE, Walser M, Buffinton GA, et al:  A simple method of estimating progression of chronic renal failure . Lancet 2:1326-1328, 1976;.
Rutherford WE, Blondin J, Miller JP, et al:  Chronic progressive renal disease: Rate of change of serum creatinine concentration . Kidney Int 11:62-70, 1977;.
Chan JCM, Beale MG:  The progression of end-stage kidney disease in children: Effect of dietary therapy , in Chan JCM (ed): Symposium on Kidney Failure: Dialysis and Transplantation in Childhood. Clin Proc Child Hosp Natl Med Center 30:202-206, 1974;.
Hausler MR, Baylink EJ, Hughes MR, et al:  The assay of 1-alpha 25 dihydroxyvitamin D3: Physiologic and pathologic modulation of circulating hormone levels . Clin Endocrinol 5( (suppl) ): 151, 1976;.
Avioli LV, Teitelbaum SL:  The renal osteodystrophies , in Brenner M, Rector FC (eds): The Kidney . Philadelphia, WB Saunders Co, 1976;, pp 1542-1591.
Berson SA, Yalow RS:  Parathyroid hormone in plasma in adenomatous hyperparathyroidism, uremia and bronchogenetic carcinoma . Sci NY 153:907-909, 1966;.
Arnaud CD:  Hyperparathyroidism and renal failure . Kidney Int 4:89-94, 1973;.
Reiss E, Canterbury JM, Kanter A:  Circulating parathyroid hormone concentration in chronic renal insufficiency . Arch Intern Med 124:417-421, 1969;.
Holick MF, deBlanco MD, Clark MB, et al:  The metabolism of (6-3H) 1 alpha-hydroxycholecalciferol to (6-3H) 1 alpha-25-dihydroxycholecalciferol in a patient with renal insufficiency . J Clin Endocrinol Metab 44:595-598, 1977;.
Evans IM, Boulton-Jones M, Doyle FH, et al:  The clinical use of synthetic 1,25-dihydroxycholecalciferol . Calcif Tissue Res 21( (suppl) ):236-241, 1976;.
Ellis HA, Pert KM:  Iliac bone marrow mast cells in relation to the renal osteodystrophy of patients treated with hemodialysis . J Clin Pathol 29:502-516, 1976;.
Chesney RW, Moorthy AV, Eisman JA, et al:  Increased growth after long-term oral 1,25-vitamin D3 in childhood renal osteodystrophy . N Engl J Med 298:238-242, 1978;.
Piel CF, Roof BS, Avioli LV:  Metabolism of tritiated 25-hydroxycholecalciferol in chronically uremic children before and after successful renal homotransplantation . J Clin Endocrinol Metab 37:944-948, 1973;.

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Roof BS, Gordon GS, Goldman L, et al:  Berson and Yalow's radio immunoassay for parathyroid hormone PTH: A clinical progress report . Mt Sinai J Med NY 40:433-447, 1973;.
Balsan S, Garabedian M, Sogniard R, et al:  1,25-dihydroxyvitamin D3 and 1-alpha-hydroxyvitamin D3 in children: Biologic and therapeutic effects in nutritional rickets and different types of vitamin D resistance . Pediatr Res 9:586-593, 1975;.
Brickman AS, Coburn JW, Massry SG, et al:  1,25-dihydroxyvitamin D, in normal man and in patients with renal failure . Ann Intern Med 80:161-168, 1974;.
Chan JCM, Oldham SB, Holick MF, et al:  1-α-hydroxyvitamin D3 in chronic renal failure: A potent analogue of the kidney hormone, 1,25-dihydroxycholecalciferol . JAMA 234:47-52, 1975;.
Chan JCM, Oldham SB, DeLuca HF:  Effectiveness of 1-alpha-hydroxyvitamin D3 in children with renal osteodystrophy associated with hemodialysis . J Pediatr 90:820-824, 1977;.
Wang M, Rao DD, Mauger I, et al:  Nutritional aspects of children on hemodialysis or following renal transplantation , in Chan JCM (ed): Symposium on Kidney Failure: Dialysis and Transplantation in Childhood. Clin Proc Child Hosp Natl Med Center 30:259-264, 1974;.
Chan JCM:  The effect of milk formulae on acid-balance . Nutr Metab 16:140-154, 1974;.
Mitch WE, Walser M, Buffinton GA, et al:  A simple method of estimating progression of chronic renal failure . Lancet 2:1326-1328, 1976;.
Rutherford WE, Blondin J, Miller JP, et al:  Chronic progressive renal disease: Rate of change of serum creatinine concentration . Kidney Int 11:62-70, 1977;.
Chan JCM, Beale MG:  The progression of end-stage kidney disease in children: Effect of dietary therapy , in Chan JCM (ed): Symposium on Kidney Failure: Dialysis and Transplantation in Childhood. Clin Proc Child Hosp Natl Med Center 30:202-206, 1974;.
Hausler MR, Baylink EJ, Hughes MR, et al:  The assay of 1-alpha 25 dihydroxyvitamin D3: Physiologic and pathologic modulation of circulating hormone levels . Clin Endocrinol 5( (suppl) ): 151, 1976;.
Avioli LV, Teitelbaum SL:  The renal osteodystrophies , in Brenner M, Rector FC (eds): The Kidney . Philadelphia, WB Saunders Co, 1976;, pp 1542-1591.
Berson SA, Yalow RS:  Parathyroid hormone in plasma in adenomatous hyperparathyroidism, uremia and bronchogenetic carcinoma . Sci NY 153:907-909, 1966;.
Arnaud CD:  Hyperparathyroidism and renal failure . Kidney Int 4:89-94, 1973;.
Reiss E, Canterbury JM, Kanter A:  Circulating parathyroid hormone concentration in chronic renal insufficiency . Arch Intern Med 124:417-421, 1969;.
Holick MF, deBlanco MD, Clark MB, et al:  The metabolism of (6-3H) 1 alpha-hydroxycholecalciferol to (6-3H) 1 alpha-25-dihydroxycholecalciferol in a patient with renal insufficiency . J Clin Endocrinol Metab 44:595-598, 1977;.
Evans IM, Boulton-Jones M, Doyle FH, et al:  The clinical use of synthetic 1,25-dihydroxycholecalciferol . Calcif Tissue Res 21( (suppl) ):236-241, 1976;.
Ellis HA, Pert KM:  Iliac bone marrow mast cells in relation to the renal osteodystrophy of patients treated with hemodialysis . J Clin Pathol 29:502-516, 1976;.
Chesney RW, Moorthy AV, Eisman JA, et al:  Increased growth after long-term oral 1,25-vitamin D3 in childhood renal osteodystrophy . N Engl J Med 298:238-242, 1978;.
Piel CF, Roof BS, Avioli LV:  Metabolism of tritiated 25-hydroxycholecalciferol in chronically uremic children before and after successful renal homotransplantation . J Clin Endocrinol Metab 37:944-948, 1973;.
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