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Vitamin D insufficiency and hyperparathyroidism in children with chronic kidney disease
- Source :
- Pediatric Nephrology. 23:1831-1836
- Publication Year :
- 2008
- Publisher :
- Springer Science and Business Media LLC, 2008.
-
Abstract
- Chronic kidney disease (CKD) is associated with altered calcium-phosphate homeostasis and hyperparathyroidism due to decreased activity of 1alpha-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 levelsor =30 ng/ml, with overall mean of 26.4 +/- 14.3 ng/ml. PTH for patients with 25(OH)D3 levels30 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 (p0.001) 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.
- Subjects :
- Male
Nephrology
medicine.medical_specialty
Adolescent
Gastroenterology
vitamin D deficiency
Calcitriol
Internal medicine
Prevalence
medicine
Vitamin D and neurology
Humans
Child
Retrospective Studies
Hyperparathyroidism
business.industry
Retrospective cohort study
Vitamin D Deficiency
medicine.disease
Ergocalciferol
Endocrinology
Parathyroid Hormone
Child, Preschool
Chronic Disease
Pediatrics, Perinatology and Child Health
Female
Kidney Diseases
business
Homeostasis
medicine.drug
Kidney disease
Subjects
Details
- ISSN :
- 1432198X and 0931041X
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Pediatric Nephrology
- Accession number :
- edsair.doi.dedup.....0148f56c0ec937754023bf2cb86bd9bb