Serum Levels of 1,25‐Dihydroxyvitamin D in Children Receiving Parenteral Nutrition with Reduced Aluminum Content

Abstract

Both adults and children receiving total parenteral nutrition (TPN) have been found to have low serum levels of 1,25(OH)2‐vitamin D [1,25(OH)2D]. Many of these were subsequently found to have inadvertently received large quantities of aluminum in the TPN solution. Since aluminum administration to dogs is associated with a fall in serum 1,25(OH)2D levels, the present study was designed to prospectively follow serum levels of this sterol while patients received a TPN solution low in aluminum. Nine children received a TPN solution comparable to that previously administered to children who demonstrated low serum levels of 1,25(OH)2D, except for a moderately reduced phosphorus and markedly reduced aluminum content. Serum was obtained during the first and fourth weeks of TPN treatment and analyzed for 1,25(OH)2D, 25‐hydroxyvitamin D [25(OH)D], immuno‐reactive parathyroid hormone (iPTH), calcium, and phosphorus. Results revealed normal or high serum levels of 1,25(OH)2D and normal levels of iPTH, calcium, phosphorus, and 25(OH)D. Thus, low aluminum‐containing TPN does not produce a fall in serum 1,25(OH)2D, providing evidence that aluminum may have been a factor in causing the reduced serum 1,25(OH)2D in those children previously receiving TPN.