Journal
KIDNEY INTERNATIONAL
Volume 81, Issue 7, Pages 690-697Publisher
ELSEVIER SCIENCE INC
DOI: 10.1038/ki.2011.431
Keywords
children; focal segmental glomerulosclerosis; hypoalbuminemia; parathyroid hormone; vitamin D
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Funding
- NIH [R01-DK060030, R01-HD040714, K24-DK076808, UL1-RR-024134, UL1-RR-026314]
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Here we determined if vitamin D deficiency is more common in children with chronic kidney disease compared to healthy children. In addition, we sought to identify disease-specific risk factors for this deficiency, as well as its metabolic consequences. We found that nearly half of 182 patients (ages 5 to 21) with kidney disease (stages 2 to 5) and a third of age-matched 276 healthy children were 25-hydroxyvitamin D deficient (<20 ng/ml). The risk of deficiency was significantly greater in advanced disease. Focal segmental glomerulosclerosis and low albumin were significantly associated with lower 25-hydroxyvitamin D, which, in turn, was associated with significantly higher intact parathyroid hormone levels. We found that 25-hydroxyvitamin D levels were positively associated with 1,25-dihydroxyvitamin D, the relationship being greatest in advanced disease (significant interaction), and inversely related to those of inflammatory markers C-reactive protein and IL-6. The association with C-reactive protein persisted when adjusted for the severity of kidney disease. Thus, lower 25-hydroxyvitamin D may contribute to hyperparathyroidism, inflammation, and lower 1,25-dihydroxyvitamin D in children and adolescents, especially those with advanced kidney disease. Kidney International (2012) 81, 690-697; doi:10.1038/ki.2011.431; published online 28 December 2011
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