Regulation of Bone Formation in Renal Osteodystrophy

Regulation of Bone Formation in Renal Osteodystrophy

To examine the effects of two types of active vitamin D (calcitriol and doxercalciferol) and two phosphate binders (sevelamer and calcium carbonate) on the bone disease and blood tests of children with kidney failure

Pediatric patients treated with CCPD who displayed biochemical and bone biopsy proven secondary hyperparathyroidism were randomly assigned to one of 2 vitamin D analogues (calcitriol or doxercalciferol) and one of two phosphate binders (sevelamer or calcium carbonate) in a two by two factorial designed prospective trial. Serum biochemical measurements were obtained at baseline and monthly throughout the 8 months of the trial. Bone biopsy was obtaine at baseline and repeated at study completion.

Inclusion Criteria:

• Stable end-stage kidney disease treated with continuous cycling peritoneal dialysis,
• Biochemical evidence of secondary hyperparathyroidism (PTH>400 pg/ml) with bone biopsy evidence of high turnover bone disease

Exclusion Criteria:

• History of parathyroidectomy
• Growth hormone
• Prednisone, or other immunosuppressant medication within the past year.
• Recent history of medication non-compliance.