Renal function and histology after long-term vitamin D therapy of vitamin D refractory rickets

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Since large amounts of vitamin D are potentially nephrotoxic, renal function and histology were studied in 14 patients with vitamin D refractory rickets treated with high dosages of vitamin D for long periods. One had previously had severe and protracted hypercalcemia; this patient showed altered renal function and histology. Renal function was normal in the other patients, but one had small amounts of microscopic medullary calcification. It is concluded that vitamin D therapy is relatively safe if strictly controlled to avoid hypercalcemia. Significant permanent lesions causing impaired renal function occurred only after severe and prolonged hypercalcemia.