Vitamin D Status in Children with Nephrotic Syndrome

Abstract

Background: Children with nephrotic syndrome (NS) are treated for 12 weeks with prednisolone regarding the damage to the bones. Deficiency in the level of vitamin D damages the bones. Assessment of vitamin D status in children with NS is based on serum 25OHD3 level taking into consideration the type of steroid susceptible (SS), steroid dependent (SD), and steroid resistance (SR) nephrotic syndrome (NS). Methods: This study was a prospective study on children with the first visit of NS before treatment with prednisolone. The glomerular filtration rate (GFR) was calculated with Schwartz formula, and only sick people with normal GFR were included in the study. Analysis of 218 children aged 1-13 years, median 9.5 [108 with SSNS, 64 with SDNS, and 46 with SRNS] was performed. Serum concentrations of 1,25(OH)2 D3, calcium, phosphorus, and creatinine were measured. The correlation of 25OHD3 with the type of nephrotic syndrome, seasons, gender, and age was investigated. Results: A total of 218 children were examined. Vitamin D level was deficient (< 10 ng/mL) in 79% of SRNS, 83% of SDNS, and 17% of SSNS group (P value 0.0001), insufficient (10 - 30 ng/mL) in 81% of SRNS, 73% of SDNS, and 9% of SSNS group (P value = 0.0003), and sufficient (30 - 150 ng/mL) in 91% of SSNS, 17% of SDNS, and 7% of SRNS group (P value = 0.002). Conclusions: Our results suggest the necessity of developing new strategies in vitamin D supplementation in children with INS.