Abstract
Background: Vitamin D is an essential component of skeletal development. Although hypovitaminosis D has been widely observed, little data for vitamin D status in pediatric patients with chronic kidney disease (CKD) has been reported. The aim of this study was to assess the prevalence of abnormal vitamin D status and analyze factors associated with inadequate 25(OH) vitamin D (25(OH)D) levels in children with CKD. Methods: Serum 25(OH)D levels and other parameters associated with vitamin D status were evaluated by a cross-sectional study of pediatric patients with predialysis CKD stage 2-5 at Samsung Medical Center located in Seoul, Republic of Korea. Vitamin D deficiency and insufficiency were defined as a serum 25(OH)D level < 20 ng/mL and 20- 30 ng/mL, respectively. Results: Of the 113 pediatric patients with CKD, vitamin D deficiency or insufficiency was found in 77.8% of the patients and 54.9% had a diagnosis of vitamin D deficiency with a serum 25(OH)D levels below 20 ng/mL. An increasing prevalence of vitamin D deficiency in advanced CKD was observed Age and PTH levels were negatively associated with 25(OH)D levels in pediatric CKD patients. Conclusion: This study demonstrated that a prevalence of 25(OH)D insufficiency and deficiency are common in children with CKD. The age effect on abnormal vitamin D status was observed in pediatric patients with CKD, and future studies to adjust the guideline for vitamin D supplementation according to the age is needed.
Highlights
The vitamin D is an essential factor for skeletal development, and its deficiency can cause growth retardation and skeletal deformities such as rickets [1,2]
The vitamin D receptor (VDR) has been reported to be found in endocrine glands, cardiovascular tissues, and hematopoietic cells, and vitamin D has been supposed to be involved to both skeletal disease and nonskeletal diseases including metabolic syndrome, insulin resistance, obesity, cardiovascular diseases, infection, allergy, and cancer [2,3,4,5]
We investigated the prevalence of vitamin D deficiency, other factors which might be associated with vitamin D status, and the optimal vitamin D levels for intervention in pediatric chronic kidney disease (CKD) patients
Summary
The vitamin D is an essential factor for skeletal development, and its deficiency can cause growth retardation and skeletal deformities such as rickets [1,2]. Among the various forms of vitamin D in body, serum 25(OH) D is used as a parameter to reflect vitamin D status because 25(OH) D can activate VDR and contribute to the overall vitamin D effect on the target organs [2,3]. Hypovitaminosis D has been widely observed, little data for vitamin D status in pediatric patients with chronic kidney disease (CKD) has been reported. The aim of this study was to assess the prevalence of abnormal vitamin D status and analyze factors associated with inadequate 25(OH) vitamin D (25(OH)D) levels in children with CKD
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