BACKGROUND: The role of vitamin D status in patients with renal insufficiency and its relation to dietary intake and parathyroid hormone (PTH) secretion is of utmost interest given the morbidity and mortality associated with the disordered mineral metabolism seen in chronic kidney disease (CKD). METHODS: We conducted a cross-sectional study of 100 pediatric patients with a diagnosis of CKD stage 1-5 at Children's Hospital Boston, measuring blood levels of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], and parathyroid hormone and obtaining data on nutrient intake and other variables related to vitamin D status. RESULTS: Subjects ranged in age from 6 months to 18 years, and 60 were male, 40 female. Of the 100 patients, 16 % were deficient in 25(OH)D (≤ 20 ng/mL) and another 24 % were insufficient (≤ 30 ng/mL), with 40 % in the suboptimal range. Serum 25(OH)D and dietary vitamin D intake were not correlated. CONCLUSIONS: We found a high prevalence of hyperparathyroidism in early-stage CKD and a significant relationship between 25(OH)D and PTH regardless of calcitriol level. Our study results support the suggestion that optimization of vitamin D levels may provide additional benefit in preventing or improving hyperparathyroidism in patients with early CKD and likely remains important as an adjunctive therapy in children with advanced CKD.
BACKGROUND: The role of vitamin D status in patients with renal insufficiency and its relation to dietary intake and parathyroid hormone (PTH) secretion is of utmost interest given the morbidity and mortality associated with the disordered mineral metabolism seen in chronic kidney disease (CKD). METHODS: We conducted a cross-sectional study of 100 pediatric patients with a diagnosis of CKD stage 1-5 at Children's Hospital Boston, measuring blood levels of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], and parathyroid hormone and obtaining data on nutrient intake and other variables related to vitamin D status. RESULTS: Subjects ranged in age from 6 months to 18 years, and 60 were male, 40 female. Of the 100 patients, 16 % were deficient in 25(OH)D (≤ 20 ng/mL) and another 24 % were insufficient (≤ 30 ng/mL), with 40 % in the suboptimal range. Serum 25(OH)D and dietary vitamin D intake were not correlated. CONCLUSIONS: We found a high prevalence of hyperparathyroidism in early-stage CKD and a significant relationship between 25(OH)D and PTH regardless of calcitriol level. Our study results support the suggestion that optimization of vitamin D levels may provide additional benefit in preventing or improving hyperparathyroidism in patients with early CKD and likely remains important as an adjunctive therapy in children with advanced CKD.
Authors: Mark R Haussler; G Kerr Whitfield; Ichiro Kaneko; Ryan Forster; Rimpi Saini; Jui-Cheng Hsieh; Carol A Haussler; Peter W Jurutka Journal: Rev Endocr Metab Disord Date: 2012-03 Impact factor: 6.514
Authors: Dagmara Borzych; Lesley Rees; Il Soo Ha; Annabelle Chua; Patricia G Valles; Maria Lipka; Pedro Zambrano; Thurid Ahlenstiel; Sevcan A Bakkaloglu; Ana P Spizzirri; Laura Lopez; Fatih Ozaltin; Nikoleta Printza; Pankaj Hari; Günter Klaus; Mustafa Bak; Andrea Vogel; Gema Ariceta; Hui Kim Yap; Bradley A Warady; Franz Schaefer Journal: Kidney Int Date: 2010-09-01 Impact factor: 10.612
Authors: Juhi Kumar; Kelly McDermott; Alison G Abraham; Lisa Aronson Friedman; Valerie L Johnson; Frederick J Kaskel; Susan L Furth; Bradley A Warady; Anthony A Portale; Michal L Melamed Journal: Pediatr Nephrol Date: 2015-08-26 Impact factor: 3.714