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Title of Journal: Pediatr Nephrol

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Abbravation: Pediatric Nephrology

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Springer-Verlag

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DOI

10.1016/0365-1789(66)90017-8

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1432-198X

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Searching the optimal PTH target range in children

Authors: Dieter Haffner Franz Schaefer
Publish Date: 2012/08/15
Volume: 28, Issue: 4, Pages: 537-545
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Abstract

The treatment of the mineral and bone disorder associated with chronic kidney disease CKDMBD remains a major challenge in pediatric patients The principal aims of therapeutic measures are not only to prevent the debilitating skeletal complications and to achieve normal growth but also to preserve longterm cardiovascular health Serum parathyroid hormone PTH levels are used as a surrogate parameter of bone turnover Whereas it is generally accepted that serum calcium and phosphate levels should be kept within the range for age current pediatric consensus guidelines differ markedly with respect to the optimal PTH target range and operate on a limited evidence base Recently the International Pediatric Dialysis Network IPPN established a global registry collecting detailed clinical and biochemical information including data relevant to CKDMBD in children on chronic peritoneal dialysis PD This review highlights the current evidence basis regarding the optimal PTH target range in pediatric CKD patients and reassesses the current guidelines in view of the outcome data collected by the IPPN registry Based on a comprehensive evaluation of CKDMBD outcome measures in this global patient cohort a PTH target range of 17–3 times the upper limit of normal ie 100–200 pg/ml appears reasonable in children undergoing chronic PD

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