Vitamin D Resistance in Osteomalacia after Ureterosigmoidostomy

Abstract

Osteomalacia after ureterocolic anastomosis has been recognized for 25 years.¹ Its cause is uncertain, but both renal damage and acidosis may contribute.^{2 3 4} A requirement for vitamin D is variable: although vitamin D "resistance" has been documented³ other workers have suggested that only correction of acidosis, with little or no added vitamin D, is necessary.⁵ 25-Hydroxycholecalciferol is several times more potent than the parent vitamin in the treatment of various forms of rickets^{6 , 7} and is effective in renal osteodystrophy.^{8 9 10} The reason for its superior potency has been somewhat clarified by recent comparison of relative plasma 25-hydroxyvitamin D levels produced in different . . .