Osteodystrophy in Children with the Renal form of Primary Hyperparathyroidism

Abstract

Introduction: PHPT was diagnosed on the basis of a study of the content of total calcium and inorganic phosphorus in the blood and in daily urine, ionized calcium in the blood, exercise tests with calcium and sodium chloride, the content of parathyroid hormone (PTH), calcitonin (CT), vitamin D and cyclic 3,5 β-adenosine monophosphate (cAMP) in serum. Materials and Methods: A total of 2100 children aged 1 to 15 years with patients with urolithiasis were examined, of which 52 (2.5%) children were diagnosed with primary hyperparathyroidism (PHPT). The renal form (RF) of PHPT was 29 (55.7%) and the mixed form (MF) (damage to the kidneys and bones) of PHPT was 23 (44.2%) patients. To detect bone damage, we studied the activity of alkaline phosphatase (ALPL) and X-ray densitometry of the bones of the hand and ultrasound osteometry of the bones. Results: High rates of alkaline phosphatase (ALPL) and low rates of echoosteometry were observed in children with impaired renal function and had a direct relationship with the number and size of formed stones and osteoporosis of bones. Discussion: The study of alkaline phosphatase (ALPL) activity and bone echoostometry makes it possible to assess the severity of osteystrophy and accordingly, to differentiate PHPT by forms (renal and mixed) and the severity of the disease.