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Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease

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Abstract

Vitamin D insufficiency is common in patients with chronic kidney disease (CKD) and may contribute to mineral bone disease. In a prospective interventional study, we estimated the prevalence of vitamin D insufficiency (serum 25-hydroxyvitamin D3 [25OHD] < 30 ng/ml), and examined the effect of high-dose (600,000 IU) cholecalciferol supplementation after 6 weeks on serum 25OHD and parathyroid hormone (PTH) levels in children with CKD stages 2–4. Forty-two children (86% boys) with a mean age of 7.7 ± 3.8 (range 2-–5) years were studied. Thirty-seven children (82.1%) had vitamin D insufficiency; 18 (42.8%) had 25OHD < 16 ng/ml. The median 25OHD increased significantly from 16.7 (95% CI 11.3, 19.8) to 46.2 (34.5, 44.6) ng/ml in patients with vitamin D insufficiency (P <0.001). The median PTH decreased significantly from 51.3 (95% CI 46.7, 71.5) to 37.1 (29.0, 54.6) pg/ml (P = 0.003). Nineteen patients (47.5%) had >30% reduction in the PTH after supplementation. Serum calcium, phosphorus, and estimated GFR did not change significantly. We conclude that vitamin D insufficiency is highly prevalent in children with CKD stages 2–4. High-dose cholecalciferol is safe and effective in correcting vitamin D insufficiency and results in a significant reduction in PTH levels in vitamin D-insufficient children.

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Authors and Affiliations

  1. Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Pankaj Hari, Ashima Gulati, Puneet Mahajan & Arvind Bagga

  2. Department of Endocrinology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Nandita Gupta

  3. Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Smriti Hari

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  1. Pankaj Hari
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  2. Nandita Gupta
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Correspondence to Pankaj Hari.

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Hari, P., Gupta, N., Hari, S. et al. Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease. Pediatr Nephrol 25, 2483–2488 (2010). https://doi.org/10.1007/s00467-010-1639-2

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  • DOI: https://doi.org/10.1007/s00467-010-1639-2

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