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- Title
Racial-ethnic differences in chronic kidney disease-mineral bone disorder in youth on dialysis.
- Authors
Laster, Marciana; Soohoo, Melissa; Streja, Elani; Elashoff, Robert; Jernigan, Stephanie; Langman, Craig B.; Norris, Keith C.; Salusky, Isidro B.; Kalantar-Zadeh, Kamyar
- 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.
- Subjects
BONE metabolism; RICKETS treatment; PHOSPHATES analysis; ALKALINE phosphatase; BIOMARKERS; BLACK people; CALCIUM; CONFIDENCE intervals; ETHNIC groups; HEMODIALYSIS; HEMODIALYSIS patients; HISPANIC Americans; MINERALS; MULTIVARIATE analysis; PARATHYROID hormone; RACE; SEX distribution; WHITE people; ADOLESCENCE; CHILDREN
- Publication
Pediatric Nephrology, 2019, Vol 34, Issue 1, p107
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-018-4048-6