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Author Notes:

Correspondence: Isidro B. Salusky, MD, Division of Pediatric Nephrology, David Geffen School of Medicine at UCLA, 10833 Le Conte, Box 951752, Los Angeles, CA 90095-1752, Tel: (310) 206-6987, Fax: (310) 825-0442, isalusky@mednet.ucla.edu.

We thank DaVita Clinical Research (DCR) for providing statistically de-identified data used in this study.

KKZ has received honoraria and/or support from Abbott, Abbvie, Alexion, Amgen, American Society of Nephrology, Astra-Zeneca, AVEO, Chugai, DaVita, Fresenius, Genetech, Haymarket Media, Hospira, Kabi, Keryx, National Institutes of Health, National Kidney Foundation, Relypsa, Resverlogix, Sanofi, Shire, Vifor, ZS-Pharma.

Dr. Isidro B. Salusky is a consultant for Keryx and has received honoraria from Amgen, Abbvie and OPKO.

Dr Craig B Langman is a consultant for Alexion Pharma Inc, Dicerna Pharma Inc, and Janssen Pharma Inc.

Subject:

Research Funding:

The work in this manuscript has been performed with the support of the National Institute of Diabetes, Digestive and Kidney Disease of the National Institute of Health research grants R01-DK95668 (KKZ), K24-DK091419 (KKZ), R01-DK078106 (KKZ) and T32-DK104687 (ML).

KKZ is supported by philanthropic grants from Mr. Harold Simmons, Mr. Louis Chang, Mr. Joseph Lee and AVEO.

KN is supported by NIH grants UL1TR000124 and P30AG021684.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • Urology & Nephrology
  • Biochemical markers of bone turnover
  • Parathyroid-related disorders
  • Chronic kidney disease-mineral bone disease
  • Children
  • Dialysis
  • PARATHYROID-HORMONE
  • AFRICAN-AMERICAN
  • SECONDARY HYPERPARATHYROIDISM
  • VITAMIN-D
  • SOCIOECONOMIC-STATUS
  • MAJOR DETERMINANT
  • WHITE-CHILDREN
  • CORTICAL BONE
  • BLACK
  • RACE

Racial-ethnic differences in chronic kidney disease-mineral bone disorder in youth on dialysis

Tools:

Journal Title:

Pediatric Nephrology

Volume:

Volume 34, Number 1

Publisher:

, Pages 107-115

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: Studies in healthy pediatric populations and adults treated with dialysis demonstrate higher parathyroid hormone (PTH) and lower 25-hydroxyvitamin D levels in African-Americans. Despite these findings, African-Americans on dialysis demonstrate greater bone strength and a decreased risk of fracture compared to the Caucasian dialysis population. The presence of such differences in children and young adult dialysis patients is unknown. Methods: Differences in the markers of mineral and bone metabolism (MBM) were assessed in 661 incident dialysis patients (aged 1 month to < 21 years). Racial-ethnic differences in PTH, calcium, phosphate, and total alkaline phosphatase (AP) activity were analyzed over the first year of dialysis using multivariate linear mixed models. Results: African-American race predicted 23% higher serum PTH (95% CI, 4.7–41.3%) when compared to Caucasian patients, while Hispanic ethnicity predicted 17.5% higher PTH (95% CI, 2.3–38%). Upon gender stratification, the differences in PTH were magnified in African-American and Hispanic females: 38% (95% CI, 14.8–69.8%) and 28.8% (95% CI, 4.7–54.9%) higher PTH compared to Caucasian females. Despite higher PTH values, African-American females persistently demonstrated up to 10.9% lower serum AP activity (95% CI, − 20.6–− 0.7%). Conclusions: There are racial-ethnic differences in the markers of MBM. Higher PTH is seen in African-American and Hispanic children and young adults on dialysis with a magnification of this difference amongst the female population. There is a need to consider how factors like race, ethnicity, and gender impact the goal-targeted treatment of MBM disorders.

Copyright information:

© 2018, IPNA.

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