Vitamin D insufficiency and hyperparathyroidism in children with chronic kidney disease
- 1 October 2008
- journal article
- Published by Springer Science and Business Media LLC in Pediatric Nephrology
- Vol. 23 (10), 1831-1836
- https://doi.org/10.1007/s00467-008-0842-x
Abstract
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.Keywords
This publication has 27 references indexed in Scilit:
- Changes in Serum 25-Hydroxyvitamin D and Plasma Intact PTH Levels Following Treatment With Ergocalciferol in Patients With CKDAmerican Journal of Kidney Diseases, 2007
- Vitamin D Deficiency and Secondary Hyperparathyroidism Among Patients with Chronic Kidney DiseaseThe American Journal of the Medical Sciences, 2007
- Impact of Ergocalciferol Treatment of Vitamin D Deficiency on Serum Parathyroid Hormone Concentrations in Chronic Kidney DiseaseAmerican Journal of Nephrology, 2007
- Impact of calcium and vitamin D therapy on arterial and cardiac disease in young adults with childhood-onset end stage renal diseaseNephrology Dialysis Transplantation, 2007
- MastheadAmerican Journal of Kidney Diseases, 2005
- Serum levels of 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D, and 25-hydroxyvitamin D in nondialyzed patients with chronic renal failureKidney International, 1999
- Ketodiet, physiological calcium intake and native vitamin D improve renal osteodystrophyKidney International, 1992
- Vitamin D and the kidneyKidney International, 1987
- Comparison of 1α-hydroxycholecalciferol and 25-hydroxycholecalciferol in the treatment of renal osteodystrophy: Greater effect of 25-hydroxycholecalciferol on bone mineralizationKidney International, 1979
- 25-hydroxycholecalciferol stimulation of muscle metabolism.JCI Insight, 1975