Vitamin D status of children receiving chronic dialysis

作者：Dibas Basema I; Warady Bradley A^*

来源：Pediatric Nephrology, 2012, 27(10): 1967-1973.

DOI：10.1007/s00467-012-2203-z

• Chronic kidney disease (CKD)
• Vitamin 25(OH) D-3
• Hyperparathyroidism
• Ergocalciferol

Patients receiving chronic dialysis therapy are presumed to be at risk for 25(OH) D-3 deficiency, but little information is available on its prevalence, manifestations of deficiency, and the impact of ergocalciferol supplementation.
A single-center, retrospective study of 51 prevalent pediatric patients on hemodialysis or peritoneal dialysis was conducted to address these issues.
Forty of 51 (78.4 %) patients had low (< 30 ng/ml) 25(OH) D-3 levels. Of these, 2 % had values < 5 ng/ml, 41.2 % 5-15 ng/ml, and 35.3 % 16-30 ng/ml. Age > 12 years, non-Caucasian race and > 12-month duration of dialysis were significantly associated with low 25(OH) D-3 levels (p = 0.006, p = 0.05, and p = 0.04, respectively). Twenty-three of the 40 patients deficient in 25(OH) D-3 received repletion therapy with ergocalciferol and had a follow-up level at an average of 2 months following completion of a single course of therapy; 14 (60 %) of the levels were normal. Mean baseline intact parathyroid hormone (iPTH) for patients with 25(OH) D-3 levels a parts per thousand currency signaEuro parts per thousand 30 was 478.68 +/- 474.01 pg/ml and treatment with ergocalciferol was not associated with a significant decrease in the mean iPTH value (p = 0.45).
We conclude that low 25(OH) D-3 levels are common in pediatric patients receiving dialysis and require attention in accordance with current practice guidelines.

• 出版日期2012-10