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pediatric hyperphosphatemia

Kiran Imran, Mirza Naqi Zafar, Uzma Ozair, Sadia Khan, Syed Adibul Hasan Rizvi
The goal of this study was to investigate metabolic risk factors in pediatric stone formers in an emerging economy. A prospective, data collection enrolled 250 children age <1-15 years at our center. Risk factors were evaluated by gender and in age groups <1-5, 6-10 and 11-15 years. Patients were evaluated for demographics, blood and 24 h urine for calcium, magnesium, phosphate, uric acid, electrolytes and additional protein, citrate, ammonia and oxalate in urine. All reported values were two sided and statistical significance was considered at p value ≤0...
October 15, 2016: Urolithiasis
Jacob M Taylor, Leah Oladitan, Angela Degnan, Sarah Henderson, Hongying Dai, Bradley A Warady
OBJECTIVE: Abnormal phosphorus homeostasis is among the medley of metabolic disturbances commonly associated with chronic kidney disease. We sought to determine the psychosocial factors that create barriers to controlling serum phosphorus levels in children on dialysis and to evaluate the perceptions of children and caregivers on the ease or difficulty of following a dietary phosphorus restriction and taking phosphorus binder medications. DESIGN: Single center cross-sectional study...
July 2016: Journal of Renal Nutrition
Hsin-Hsu Chou, Ching-Yuang Lin, Yee-Hsuan Chiou, You-Lin Tain, Yi-Fan Wang, Hsin-Hui Wang, Yuan-Yow Chiou
BACKGROUND: Little information is available regarding the clinical characteristics and prevalence of complications in children with chronic kidney disease (CKD), especially in early disease stages. The objective of this study was to determine the clinical characteristics and prevalence of complications in children with predialytic CKD. METHODS: This multicenter, cross-sectional study enrolled children at all stages of predialytic CKD. Children who were between the ages of 1 year and 18 years and who fulfilled the clinical criteria of CKD were included in the study...
July 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
I Marek, K Benz, S Kusnik, P Morhart, S Botzenhardt, I Toni, W Rascher
INTRODUCTION: Enemas are used in pediatric patients with constipation. Retention of phosphate containing enemas with prolonged resorption or reduced renal elimination of phosphate can result in life-threatening hyperphosphatemia with subsequent lethal hypocalcemia and acidosis. CASE PRESENTATION: We report the case of a 6-month-old child who received phosphate-containing enema to treat acute aggravation of constipation. The used enema here was not licensed for this age group...
July 2015: Klinische Pädiatrie
Marjolein Bonthuis, Marco Busutti, Karlijn J van Stralen, Kitty J Jager, Sergey Baiko, Sevcan Bakkaloğlu, Nina Battelino, Maria Gaydarova, Bruno Gianoglio, Paloma Parvex, Clara Gomes, James G Heaf, Ludmila Podracka, Dafina Kuzmanovska, Maria S Molchanova, Tatiana E Pankratenko, Fotios Papachristou, György Reusz, Maria José Sanahuja, Rukshana Shroff, Jaap W Groothoff, Franz Schaefer, Enrico Verrina
BACKGROUND AND OBJECTIVES: Data on mineral metabolism in pediatric renal transplant recipients largely arise from small single-center studies. In adult patients, abnormal mineral levels are related to a higher risk of graft failure. This study used data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry to study the prevalence and potential determinants of mineral abnormalities, as well as the predictive value of a disturbed mineral level on graft survival in a large cohort of European pediatric renal transplant recipients...
May 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Charlotte Picard, Anne Decrequy, David Guenet, Anne Claire Bursztejn, Daniel Toledano, Nicolas Richard, Marie-Laure Kottler
UNLABELLED: Hypothyroidism is a particular condition observed in pseudohypoparathyroidism (PHP), a rare disorder characterized by parathyroid (PTH) resistance leading to hypocalcemia and hyperphosphatemia associated with a GNAS (guanine nucleotide-binding protein α-subunit) mutation (PHP1A) or epimutation (PHP1B). To determine the presence of hypothyroidism at birth we conducted a retrospective study in our cohort of patients presenting with either PHP1A (n = 116) or PHP1B (n = 99). We also investigated patients presenting at birth with congenital hypothyroidism (CH) and a eutopic thyroid gland for phosphocalcium abnormalities suggesting PTH resistance and PHP...
2015: Hormone Research in Pædiatrics
Angelo Molinaro, Dov Tiosano, Rieko Takatani, Dionisios Chrysis, William Russell, Nikolas Koscielniak, Marie-Laure Kottler, Patrizia Agretti, Giuseppina De Marco, Petteri Ahtiainen, Marta Christov, Outi Mäkitie, Massimo Tonacchera, Harald Jüppner
Hypocalcemia and hyperphosphatemia because of resistance toward parathyroid hormone (PTH) in the proximal renal tubules are the most prominent abnormalities in patients affected by pseudohypoparathyroidism type Ib (PHP-Ib). In this rare disorder, which is caused by GNAS methylation changes, resistance can occur toward other hormones, such as thyroid-stimulating hormone (TSH), that mediate their actions through G protein-coupled receptors. However, these additional laboratory abnormalities are usually not recognized until PTH-resistant hypocalcemia becomes clinically apparent...
May 2015: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Aruna Rajendran, Deepak Bansal, R K Marwaha, Sunit C Singhi
Tumor lysis syndrome (TLS) refers to the constellation of deranged metabolic state, characterized by hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia, and/or azotemia, secondary to rapid breakdown of tumor cells. It is a life threatening emergency that typically follows administration of chemotherapy or may be spontaneous. Malignancies which have a large tumor burden, rapid turnover, as well as speedy breakdown following chemotherapy are susceptible. Acute lymphoblastic leukemia and non-Hodgkins lymphoma (particularly Burkitt's lymphoma) are typically predisposed...
January 2013: Indian Journal of Pediatrics
Guido Filler, Elizabeth Roach, Abeer Yasin, Ajay P Sharma, Peter G Blake, Liju Yang
BACKGROUND: After parents raised concerns about potential lead (Pb) contamination of calcium carbonate for treatment of hyperphosphatemia in chronic kidney disease (CKD), we measured blood Pb using high-resolution sector field inductively coupled mass spectrometry in a quality-assurance investigation of ten pediatric dialysis patients (nine on hemodialysis) and six patients before dialysis. METHODS: We assessed the kidney function as cystatin C estimated glomerular filtration rate (eGFR), blood Pb levels, calcium carbonate dose, and standard laboratory parameters, as well as Pb levels in the dialysis feed water...
September 2012: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ashley H Shoemaker, Andrew A Bremer
Vitamin D deficiency is not a rare disorder, particularly in minority groups. The Institute of Medicine recommends serum 25-hydroxyvitamin (OH)D levels >20 ng/mL and The Endocrine Society recommends levels >30 ng/mL for good health. In contrast, the 2003-2006 National Health and Nutrition Examination Survey reported average total 25-(OH)D concentrations of 25.6 ± 0.4 ng/mL in whites, 19.5 ± 0.5 ng/mL in Mexican Americans, and 14.8 ± 0.4 ng/mL in blacks. Pediatric patients with vitamin D deficiency may be asymptomatic or may present either with rickets, hypocalcemia, or seizures...
April 2012: Pediatric Annals
Chad A Knoderer, Holly M Knoderer
OBJECTIVE: After transitioning our front-line amphotericin product to the liposomal formulation, we observed an increased incidence of hyperphosphatemia. We aimed to determine the incidence of hyperphosphatemia in children with oncologic disorders receiving an amphotericin B product and to establish whether the incidence varies depending on amphotericin formulation. METHODS: This retrospective review of the medical record was conducted at a tertiary, free standing children's hospital...
April 2011: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Sabyasachi Sengupta, Ravilla D Ravindran, Veena Kannusamy, Varsha Tamrakar
A 16-year-old female presented with poor vision in both eyes. On clinical examination, she had bilateral cataracts and optic disc edema bilaterally on ultrasound examination. Extensive intracranial calcification was evident on computerized tomography. Physical examination revealed short stature, rounded chubby face, dental abnormalities, brachydactyly, and obesity. Laboratory evidence of hypocalcemia, hyperphosphatemia, elevated parathyroid hormone level (indicative of pseudohypoparathyroidism) along with the constellation of phenotypical characteristics lead to a diagnosis of Albright's hereditary osteodystrophy...
January 2012: Middle East African Journal of Ophthalmology
Giulia Malaguarnera, Maria Giordano, Mariano Malaguarnera
Tumor lysis syndrome (TLS) is a common oncologic emergency in patients with hematological malignancies sensitive to cytotoxic treatment that present a high proliferative rate. High proliferative cancer rate, high sensitivity of cytotoxic treatment and renal failure represent risk factors for development of TLS. TLS is also responsible for several electrolytic alterations, such as hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. There are different established therapeutic options for the treatment of TLS such as hydration, allopurinol and rasburicase...
February 2012: Expert Review of Hematology
Guido Filler, Daisy Liu, Ajay Parkash Sharma, Joanne Grimmer
To compare the pattern of serum FGF23 levels in pediatric renal transplant recipients and GFR-matched controls. We performed a cross-sectional matched pair study in 19 stable pediatric renal transplant recipients and 19 GFR-matched controls with native CKD. After assessment for normal distribution, demographic and bone metabolism parameters were compared with Student's t-test, Wilcoxon's matched pairs (for non-normal distribution) test, and correlation analysis. The groups were comparable for anthropometric parameters, cystatin C eGFR (71...
February 2012: Pediatric Transplantation
Illias Tazi, Hatim Nafl, Jamila Elhoudzi, Lahoucine Mahmal, Mhamed Harif
INTRODUCTION: Tumor lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. REVIEW: In tumors with a high proliferative rate with a relatively large mass and a high sensitivity to cytotoxic agents, the initiation of therapy often results in the rapid release of intracellular anions, cations and the metabolic products of proteins and nucleic acids into the bloodstream. The increased concentrations of uric acid, phosphates, potassium and urea can overwhelm the body's homeostatic mechanisms to process and excrete these materials and result in the clinical spectrum associated with TLS...
September 2011: Arab Journal of Nephrology and Transplantation
M Rodriguez, M Campara, Christina Haaf
Tumor lysis syndrome (TLS) is an oncological emergency consisting of several metabolic derangements: hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. The rupture of tumor cells in cancer patients can be spontaneous or caused by anticancer therapy. Clinical manifestations of TLS include nausea, anorexia, arrhythmias or renal failure. Prevention and treatment measures include aggressive hydration and concomitant antihyperuricemic therapy. Allopurinol has historically been the only available pharmacological option...
August 2011: Drugs of Today
Ali Derakhshan, Afshin G Behbahan, Mehrzad Lotfi, Gholam-Hossein Omrani, Mohammad-Hossein Fallahzadeh, Mitra Basiratnia, Ghamar H Al-Hashemi
Incomplete resolution of abnormalities of mineral metabolism associated with CRF results in the relatively high prevalence of ROD in pediatric kidney recipients. This non-randomized, cross-sectional, and analytic-descriptive study on bone density, vitamin D, and mineral metabolism was performed in 57 children and adolescents who had received a total of 60 renal allografts in Shiraz, Iran. The height and weight of the patients were measured; their serum calcium (Ca), phosphorus (P), Alk-P, PTH, 25(OH)-vitamin D(3), BUN, creatinine, and electrolyte levels were analyzed, and a complete blood count was performed...
June 2011: Pediatric Transplantation
Massimo Cirillo, Giancarlo Bilancio, Fabiana Marcarelli
Hyperphosphatemia is pivotal in some complications secondary to kidney dysfunction. Current guidelines suggest that hyperphosphatemia due to kidney dysfunction develops only when kidney function is reduced to <50%. This paper deals with the relationship of age to phosphatemia and with the possible influences of this relationship on hyperphosphatemia due to kidney dysfunction. In pediatric age phosphatemia decreases during growth. A recent epidemiological study showed a decrease in phosphatemia with age among adults also...
January 2011: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Massimo Cirillo, Giancarlo Bilancio, Fabiana Marcarelli
Hyperphosphatemia is pivotal in some complications secondary to kidney dysfunction. Current guidelines suggest that hyperphosphatemia secondary to kidney dysfunction develops only when glomerular filtration rate is reduced well below the threshold of 60 ml/min. This paper deals with the relationship of age with serum phosphorus and with the possible influences of this relationship on hyperphosphatemia secondary to kidney dysfunction. A recent epidemiologic study shows that serum phosphorus decreases over time not only in pediatric age but also during adulthood...
November 2010: Journal of Nephrology
Katherine Wesseling-Perry, Renata C Pereira, Shobha Sahney, Barbara Gales, He-Jing Wang, Robert Elashoff, Harald Jüppner, Isidro B Salusky
We compared the effects of calcitriol and doxercalciferol, in combination with either calcium carbonate or sevelamer, on bone, mineral, and fibroblast growth factor-23 (FGF-23) metabolism in patients with secondary hyperparathyroidism. A total of 60 pediatric patients treated with peritoneal dialysis were randomized to 8 months of therapy with either oral calcitriol or doxercalciferol, combined with either calcium carbonate or sevelamer. Bone formation rates decreased during therapy and final values were within the normal range in 72% of patients...
January 2011: Kidney International
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