TY - JOUR
T1 - Vitamin D insufficiency and hyperparathyroidism in children with chronic kidney disease
AU - Menon, Shina
AU - Valentini, Rudolph P.
AU - Hidalgo, Guillermo
AU - Peschansky, Lena
AU - Mattoo, Tej K.
PY - 2008
Y1 - 2008
N2 - Chronic kidney disease (CKD) is associated with altered calcium-phosphate homeostasis and hyperparathyroidism due to decreased activity of 1α-hydroxylase and impaired activation of 25-hydroxyvitamin D3 [25(OH)D3]. In some patients these problems start earlier because of vitamin D deficiency. A retrospective review of patients followed in the chronic renal insufficiency clinic at Children's Hospital of Michigan assessed the prevalence of vitamin D deficiency in CKD stages 2-4 and evaluated the effect of treatment with ergocalciferol on serum parathormone (PTH). Blood levels of 1,25 dihydroxyvitamin D3, 25(OH)D3, and parathormone (PTH) were examined in 57 children (40 boys; mean age 10.6 years). Of 57 subjects, 44 (77.2%) had 25(OH)D3 levels ≤30 ng/ml, with overall mean of 26.4 ± 14.3 ng/ml. PTH for patients with 25(OH)D3 levels >30 ng/ml was 67.84 ± 29.09 ng/ml and in the remaining patients was elevated, at 120.36 ± 86.42 ng/ml (p = 0.05). Following ergocalciferol treatment (22), PTH decreased from 122.13 ± 82.94 ng/ml to 80.14 ± 59.24 ng/ml (p < 0.001) over a period of 3 months. We conclude that vitamin D deficiency is common in children with CKD stages 2-4 and is associated with hyperparathyroidism in the presence of normal 1,25 dihydroxyvitamin D3. Its occurrence before significant renal impairment is noteworthy. Early diagnosis and appropriate treatment is emphasized.
AB - Chronic kidney disease (CKD) is associated with altered calcium-phosphate homeostasis and hyperparathyroidism due to decreased activity of 1α-hydroxylase and impaired activation of 25-hydroxyvitamin D3 [25(OH)D3]. In some patients these problems start earlier because of vitamin D deficiency. A retrospective review of patients followed in the chronic renal insufficiency clinic at Children's Hospital of Michigan assessed the prevalence of vitamin D deficiency in CKD stages 2-4 and evaluated the effect of treatment with ergocalciferol on serum parathormone (PTH). Blood levels of 1,25 dihydroxyvitamin D3, 25(OH)D3, and parathormone (PTH) were examined in 57 children (40 boys; mean age 10.6 years). Of 57 subjects, 44 (77.2%) had 25(OH)D3 levels ≤30 ng/ml, with overall mean of 26.4 ± 14.3 ng/ml. PTH for patients with 25(OH)D3 levels >30 ng/ml was 67.84 ± 29.09 ng/ml and in the remaining patients was elevated, at 120.36 ± 86.42 ng/ml (p = 0.05). Following ergocalciferol treatment (22), PTH decreased from 122.13 ± 82.94 ng/ml to 80.14 ± 59.24 ng/ml (p < 0.001) over a period of 3 months. We conclude that vitamin D deficiency is common in children with CKD stages 2-4 and is associated with hyperparathyroidism in the presence of normal 1,25 dihydroxyvitamin D3. Its occurrence before significant renal impairment is noteworthy. Early diagnosis and appropriate treatment is emphasized.
KW - 25 Hydroxyvitamin D
KW - Chronickidney disease
KW - Ergocalciferol
KW - PTH
UR - http://www.scopus.com/inward/record.url?scp=51549115434&partnerID=8YFLogxK
U2 - 10.1007/s00467-008-0842-x
DO - 10.1007/s00467-008-0842-x
M3 - Article
C2 - 18575896
AN - SCOPUS:51549115434
VL - 23
SP - 1831
EP - 1836
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 10
ER -