Bedarf an Kalzium, Phosphor, Magnesium und Vitamin D bei Frühgeborenen Vermeidung von Knochenmineralmangel

Pohlandt, Frank

doi:10.1007/978-3-663-01934-3_8

Cited by 6 publications

(5 citation statements)

References 67 publications

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“…both ions and accrete the bone &hilling and co-workers (2 1) described the pivotal biochemiat a lower rate ' The in bone miner?1 cal changes in breast milk-and formula-fed preterm infants and was sing1e P~~~~~~ densl-we have the findings many times (22): feeding with tome@ and lo weight gain during perids lo breast milk resulted in the phosp~openic type of rickets with wk. Infants who simuluneously excreted (>Iq2 mmolt severe hypophosphatemia and an absence of urinary Pi, together L, + Pi (' Oe4 mmol/L) in more than…”

mentioning

confidence: 79%

Prevention of Postnatal Bone Demineralization in Very Low-Birth-Weight Infants by Individually Monitored Supplementation with Calcium and Phosphorus

Pohlandt

1994

Pediatr Res

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ABSTRACT. Preterm infants are more prone to bone BMA, bone mineral accretion mineral deficiency the lower their birth weight. To achieve BMC, bone mineral content the intrauterine bone mineral accretion rate postnatally, 74Pi, inorganic phosphorus low-birth-weight infants (median birth weight, 980 g; range VLBW, very low-birth-weight 430-1.580 g) were each supplemented enterally and/or parenterally with calcium and/or phosphorus in gradually increased amounts. The aim was to yield a simultaneous urinary excretion of Ca and inorganic phosphorus (Pi) at low c o n c e n~t i o n s (1-2 mmol/L) in spot urine specimens Postnatal bone mineral deficiency is a condition that is well taken twice weekly. The hypothesis was that the intrauter-known (1-6) in preterm infants and that has gained in imporine mineralization rate (4.5 mg cm-l/lOO weight gain) tance clinically since the rate of survival of VLBW infants has would be achieved postnatally in very low-birth-weight SO greatly improved. Various factors were held to be responsible infants, if they were supplemented with enough ca and/or for bone mineral deficiency, such as deficiencies of vitamin D pi to effect at least a low (1-2 mmol/L) simultaneous (7,8), Ca (7,9), Pi (10-1 3), Ca + Pi (14, 19, as well as parented urinary excretion of both ions, as compared with infants nutrition (16-20), metabolic disease, physiotherapy, long-term ventilation and, finally, treatment with furosemide. both ions and accrete the bone &hilling and co-workers (2 1) described the pivotal biochemiat a lower rate' The in bone miner?1 cal changes in breast milk-and formula-fed preterm infants and was sing1e P~~~~~~ densl-we have the findings many times (22): feeding with tome@ and lo weight gain during perids lo breast milk resulted in the phosp~openic type of rickets with wk. Infants who simuluneously excreted (>Iq2 mmolt severe hypophosphatemia and an absence of urinary Pi, together L, + Pi (' Oe4 mmol/L) in more than Of the urine with hypercalciuria. In contrast, formula-fed infants were charsamples retrospectively showed the highest bone mineral acterized by marginal hypocalcemia, no detectable urinary Ca, accretio~ 5.1 mg cm-'/loo g weight gain, which Was and showed secondary hyperparathyroidism together with hyequivalent to the fetal mineralization rate (4.5). In this perphosphaturia, i.e. the calcipenic type of rickets. The absence group the bone mineral status significantly contributed to of Pi or Ca, respectively, from the urine, is explained by maximal the variance of the bone mineral accretion rate; severely tubular reabsorption of these ions, indicating a deficiency of Ca demineralized infants showed a catch-up mineralization. A and Pi, respectively. The inorganic bone material is the crystalline significantly lower rate (2.4) was Observed in infants who mineral apatite, with the formula Ca5(P04),(0H,F) (23). Owing excreted Ca + Pi in less than half of the urinary samples. to the different amounts and ratios of Ca and Pi in breast milk Supplementation with Ca and Pi UP to the point...

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confidence: 79%

Prevention of Postnatal Bone Demineralization in Very Low-Birth-Weight Infants by Individually Monitored Supplementation with Calcium and Phosphorus

Pohlandt

1994

Pediatr Res

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“…Given an average fetal weight gain of 17 g/kg/d before 35 weeks of gestation [7] the average fetal accretion is 3.4 mmol Ca/kg/d and 2.6 mmol P/kg/ d respectively. This has been proposed as a reference mark for growing preterm infants [8,9]. However, it is important to keep in mind that in infants, children, and adolescents the mineral intake should be adjusted to the individual weight gain/growth to avoid an intake that is either too low or too high.…”

Section: Introductionmentioning

confidence: 99%

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Calcium, phosphorus and magnesium

Mihatsch¹,

Fewtrell²,

Braegger³

et al. 2018

Clinical Nutrition

108

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“…However, unusually high net intestinal Ca absorption (74%) and exceptionally low net intestinal P absorption (76 %) have been reported by those authors (24), a finding which explains the relative P deficiency. Indeed, from their data it can be calculated that in the skeleton, the deposition of Ca of 3.97 mmolkgld corresponds to a P deposit of 2.38 rnmolkdd (7). The rest of the absorbed P of 0.47 mmolkgld is inadequate for growth of the other tissues (estimated requirement about 0.54 mmoykgld) and urinary P excretion (7,…”

Section: Discussionmentioning

confidence: 99%

Effect of Calcium Supplementation on Calcium and Phosphorus Balance and Renal Net Acid Excretion in Preterm Infants Fed a Standard Formula

Manz

Diekmann²,

Stock³

1989

Acta Paediatrica

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In 19 preterm infants fed a standard formula for prematures (calcium (Ca) 13.5 mmol/l; phosphorus (P) 12.9 mmol/l), biochemical parameters of blood, serum and urine were determined before and during supplementation with Ca-L-lactate (final Ca concentration 20 mmol/l). In 8 preterm boys Ca and P balance were evaluated in addition. During Ca supplementation, the serum Ca levels, urine pH (without supplement 6.31, with supplement 6.73), and calciuria (46 mumol/kg/d vs. 98 mumol/kg/d) were increased, and urinary P (1.05 mmol/kg/d vs. 0.65 mmol/kg/d) and net acid excretion (1.70 mEq/kg/d vs. 0.89 mEq/kg/d) were decreased. Balance studies showed increased net intestinal Ca absorption during supplementation (37% vs. 56%) as well as improved Ca (0.8 mmol/kg/d vs. 1.85 mmol/kg/d) and P retention (0.97 mmol/kg/d vs. 1.45 mmol/kg/d). These data show that increased Ca intake given to optimize the Ca:P ratio improves mineral retention in preterm infants fed a standard formula. Ca and P intake should be thoroughly balanced to avoid side-effects like hypercalciuria or high renal net acid excretion.

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Bedarf an Kalzium, Phosphor, Magnesium und Vitamin D bei Frühgeborenen Vermeidung von Knochenmineralmangel

Cited by 6 publications

References 67 publications

Prevention of Postnatal Bone Demineralization in Very Low-Birth-Weight Infants by Individually Monitored Supplementation with Calcium and Phosphorus

Prevention of Postnatal Bone Demineralization in Very Low-Birth-Weight Infants by Individually Monitored Supplementation with Calcium and Phosphorus

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Calcium, phosphorus and magnesium

Effect of Calcium Supplementation on Calcium and Phosphorus Balance and Renal Net Acid Excretion in Preterm Infants Fed a Standard Formula

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