Pediatric Nephrology

, Volume 25, Issue 12, pp 2413–2430

Vitamin D deficiency and toxicity in chronic kidney disease: in search of the therapeutic window


DOI: 10.1007/s00467-010-1574-2

Cite this article as:
Querfeld, U. & Mak, R.H. Pediatr Nephrol (2010) 25: 2413. doi:10.1007/s00467-010-1574-2


Both vitamin D deficiency and vitamin D toxicity are associated with cardiovascular complications in chronic kidney disease (CKD). Clinical and experiment data indicate that the association of vitamin D levels with cardiovascular disease is best illustrated as a biphasic, or U–shaped, curve. Children and adolescents with CKD need vitamin D due to the demands of a growing skeleton, to prevent renal rickets. However, this therapy carries the risk of severe side effects and chronic toxicity. Observational studies show that vitamin D deficiency and toxicity are frequently present in patients with CKD. In view of the importance of cardiovascular complications for the long-term survival of young patients, these findings demand a judicious use of vitamin D preparations. In clinical practice, the therapeutic window is rather small, presenting a therapeutic challenge to avoid both vitamin D deficiency and toxicity.


Cardiovascular disease Chronic kidney disease Vitamin D Vitamin D receptor 

Copyright information

© IPNA 2010

Authors and Affiliations

  1. 1.Department of Pediatric NephrologyCharite Universitaetsmedizin BerlinBerlinGermany
  2. 2.Department of Pediatric NephrologyUniversity of California, San DiegoLa JollaUSA

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