Bone Disorders in Pediatric Chronic Kidney Disease: A Literature Review

SIMPLE SUMMARY: Mineral and bone disorder (MBD) is usually prevalent in pediatric patients with chronic kidney disease (CKD) and is correlated with meaningful morbidity. CKD may cause disorders in bone remodeling/modeling, which are more evident in the growing skeleton, expressing as short stature, bone pain and deformities, fractures, slipped epiphyses and ectopic calcifications. Although evaluation of bone health is a crucial part in the clinical care of children with CKD, it persists as a significant challenge for pediatricians. ABSTRACT: Intense changes in mineral and bone metabolism are frequent in chronic kidney disease (CKD) and represent an important cause of morbidity and reduced quality of life. These disorders have conventionally been defined as renal osteodystrophy and classified based on bone biopsy, but due to a lack of bone biopsy data and validated radiological methods to evaluate bone morphology in children, it has been challenging to effectively assess renal osteodystrophy in pediatric CKD; the consequence has been the suboptimal management of bone disorders in children. CKD–mineral and bone disorder (CKD-MBD) is a new expression used to describe a systemic disorder of mineral and bone metabolism as a result of CKD. CKD-MBD is a triad of biochemical imbalances in calcium, phosphate, parathyroid hormone, and vitamin D; bone deformities and soft tissue calcification. This literature review aims to explore the pathogenesis, diagnostic approach, and treatment of CKD-MBD in children and the effects of renal osteodystrophy on growing skeleton, with a specific focus on the biological basis of this peculiar condition.