Vitamin D insufficiency and treatment with oral vitamin D3 in children with chronic kidney disease

ABSTRACT

To investigate the effects of oral cholecalciferol on the levels of vitamin D3 and intact parathyroid hormone [iPTH] in children with chronic kidney disease [CKD]. We conducted a prospective uncontrolled observational study at the Pediatric Nephrology Clinic of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia between January and October 2011 to assess serum 25-hydroxyvitamin D3 [25[OH]D] and iPTH in children with CKD stages 2-5. Children with low vitamin D3 levels were commenced on cholecalciferol, 2000 IU/day. Their 25[OH]D3 and iPTH levels were reassessed, first after 3 months, then after 6 months. Data analysis was performed using the Statistical Package for Social Sciences. Paired t-test was used to compare results before and after treatment. Forty-five children [31 boys and 14 girls] were included in the study. Their mean +/- SD age was 9.6 +/- 4.6 years. There was significant improvement in 25[OH]D3 after 3 months [14.2 +/- 8.2 - 20 +/- 11.1 ng/mL] [p<0.001]. However, only 5 children reached levels >/= 30 ng/mL. There was no further improvement after 6 months of treatment [20.17 +/- 13.4 ng/mL] [p=0.65]. There was no improvement in iPTH levels after 3 and 6 months. No changes were also observed in the levels of calcium, phosphate, alkaline phosphatase, or creatinine. The administration of oral vitamin D3 at 2000 IU/day resulted in significant improvement of vitamin D levels in children with CKD, but normalized only in 11% of the patients. The treatment had no effect on iPTH levels