Children with all types of genetic and acquired bone disorders are evaluated and treated in Bone and Mineral Disorder Clinic. We also see referrals for the investigation and treatment of children with kidney stones and abnormalities in the mineral metabolism.
We perform most of the laboratory work on site in our Nephrology Research Lab to ensure timely and accurate results. Pediatric bone densitometry is available as a diagnostic tool, and the clinic provide intravenous bisphosphonate infusion therapy on an outpatient basis.
Commonly treated diagnoses include:
- Primary and secondary osteoporosis
- Osteogenesis imperfecta
- Rickets and abnormalities in mineral metabolism
- Hypophosphatemic rickets
Children's Mercy has an outstanding program that treats a wide
range of conditions including primary osteoporosis and all types of
genetic and acquired bone disorders. The team has been treating a
growing number of children with secondary osteoporosis from chronic
diseases such as cystic fibrosis, Crohn's disease, malignancies,
neurologic disorders, etc., in whom bone health is compromised by
either the primary condition or its long-term therapy.
Bone disorders can also be caused by genetic disorders, such as
osteogenesis imperfecta, sometimes called "brittle bone disease."
At Children's Mercy, a regional center for this disease, the goals
are to limit the adverse effects of the disease on bone development
to the extent possible, to eliminate or minimize the occurrence of
fractures, and with this to improve the quality of life of these
A key aspect of the successful evaluation and management of
pediatric bone disorders is densitometry, a radiologic procedure
that measures bone density. Children's Mercy Hospital is the only
institution in the area to offer pediatric bone densitometry,
allowing clinicians to quantitatively assess bone density in
For children identified with low bone density, intravenous
bisphosphonate infusion therapy is frequently the treatment of
choice and Children's Mercy has one of the largest programs in the
country for this. Research conducted here has helped to demonstrate
its efficacy in improving bone density, and lowering the risk for
fractures and bone pain.
Children's Mercy is also a center of excellence in the treatment of
hypophosphatemic rickets and receives referrals from across the
nation. This rare condition has been challenging to manage due to
the potential for serious side effects caused by the medications
used to treat the disorder. Children's Mercy helped to pioneer the
use of cinacalcet, a medication that targets calcium-sensing
receptors in the parathyroid gland, as part of the treatment
regimen. Today, we are working to develop new drugs that show even
greater promise for treating this condition. Other causes of
rickets as well as abnormalities in mineral metabolism are being
diagnosed and treated in our clinic as well.
Cases of kidney stones in children have increased significantly
in recent years, raising concerns among health care providers. Drs.
Uri Alon and Tarak Srivastava have developed a new laboratory test
named "urinary calcium/citrate ratio," which provides a better tool
for the diagnosis and treatment of children with kidney
Their research has led them to believe that education is key to
preventing kidney stones in children. Since better nutrition has
been shown to have a very positive effect on children who develop
kidney stones, the team at Children's Mercy Hospital works with
families to encourage them to reduce salt intake and eat more
fruits and vegetables. This not only reduces children's risk of
developing additional kidney stones, it improves their overall
To Make an Appointment
To make an appointment in the Bone and Mineral Disorder Clinic,
you can call the Kidney Center at (816) 234-3030 or your doctor can
make a referral. Any previous tests or radiology studies should be
sent from your doctor's office to prepare for your appointment (it
is always good to bring with you back-up copies of pertinent
information). In case the child had imaging studies done in an
outside facility, a CD containing them should be brought to be
loaded into our computer system.