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Vitamin D status of children receiving chronic dialysis

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Abstract

Background

Patients receiving chronic dialysis therapy are presumed to be at risk for 25(OH) D3 deficiency, but little information is available on its prevalence, manifestations of deficiency, and the impact of ergocalciferol supplementation.

Methods

A single-center, retrospective study of 51 prevalent pediatric patients on hemodialysis or peritoneal dialysis was conducted to address these issues.

Results

Forty of 51 (78.4 %) patients had low (<30 ng/ml) 25(OH) D3 levels. Of these, 2 % had values < 5 ng/ml, 41.2 % 5–15 ng/ml, and 35.3 % 16–30 ng/ml. Age >12 years, non-Caucasian race and > 12-month duration of dialysis were significantly associated with low 25(OH) D3 levels (p = 0.006, p = 0.05, and p = 0.04, respectively). Twenty-three of the 40 patients deficient in 25(OH) D3 received repletion therapy with ergocalciferol and had a follow-up level at an average of 2 months following completion of a single course of therapy; 14 (60 %) of the levels were normal. Mean baseline intact parathyroid hormone (iPTH) for patients with 25(OH) D3 levels ≤ 30 was 478.68 ± 474.01 pg/ml and treatment with ergocalciferol was not associated with a significant decrease in the mean iPTH value (p = 0.45).

Conclusions

We conclude that low 25(OH) D3 levels are common in pediatric patients receiving dialysis and require attention in accordance with current practice guidelines.

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Acknowledgments

We acknowledge the assistance of Guillermo Hidalgo, MD, who reviewed the manuscript, and Ashley Sherman who assisted in conducting the statistical analysis.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, The Children’s Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Basema I. Dibas & Bradley A. Warady

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  1. Basema I. Dibas
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  2. Bradley A. Warady
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Correspondence to Bradley A. Warady.

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Dibas, B.I., Warady, B.A. Vitamin D status of children receiving chronic dialysis. Pediatr Nephrol 27, 1967–1973 (2012). https://doi.org/10.1007/s00467-012-2203-z

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