Kalzium- und Phosphatsupplementierung bei Frühgeborenen unter 1500g Geburtsgewicht zur Prävention der Osteopenie
Osteopenia occurs frequently in very low birthweight infants due to calcium and phosphate deficiency. The possibility of prevention was studied in thirty preterm infants with birth-weight under 1.500 gm. Calcium intake varied from 2.5 vs. 3.75 vs. 5 mmol/kg/day, phosphate was offered in a dose of 2.5 mmol/kg/day. 40% of infants with low calcium dose showed an activity of serum alkaline phosphatase greater than 700 IU/l which is defined as a reliable marker for osteopenia. High calcium doses resulted in an increased risk for hypercalcuria (40%) (p < 0.05). Half of infants with hypercalcuria developed typical signs of nephrocalcinosis on ultrasound examination. Medium intake of calcium reduced the incidence of osteopenia at a low risk of nephrocalcinosis. We conclude, that a calcium intake of 3.75 mmol/kg/day in combination with phosphate 2.5 mmol/kg/day is sufficient for adequate bone mineralization. Calcium excretion in urine has to be observed for early diagnosis of nephrocalcinosis.
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