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Pediatric Nephrology

Published in:

01-11-2017 | Original Article

The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome

Authors: Sushmita Banerjee, Surupa Basu, Ananda Sen, Jayati Sengupta

Published in: Pediatric Nephrology | Issue 11/2017

Abstract

Background

Low serum levels of total 25-hydroxycholecalciferol (25(OH)D) occur in nephrotic syndrome (NS). We aimed to assess the effects of vitamin D3 and calcium supplementation on 25(OH)D levels, bone mineralization, and NS relapse rate in children with steroid-sensitive NS.

Methods

A randomized controlled trial (RCT) was performed in children with steroid-sensitive NS. The treatment group received vitamin D3 (60,000 IU orally, weekly for 4 weeks) and calcium supplements (500 to 1,000 mg/day for 3 months) after achieving NS remission. Blood samples for bone biochemistry were taken during relapse (T0), after 6 weeks (T1) and 6 months (T2) of randomization, whereas a lumbar DXA scan was performed at T0 and T2. Renal ultrasound was performed after study completion in the treatment group and in all patients with hypercalciuria.

Results

Of the 48 initial recruits, 43 patients completed the study. Post-intervention, 25(OH)D levels showed significant improvements in the treatment group compared with controls at T1 (p < 0.001) and T2 (p < 0.001). However, this was not associated with differences in bone mineral content (BMC) (p = 0.44) or bone mineral density (BMD) (p = 0.64) between the groups. Additionally, there was no reduction in relapse number in treated patients (p = 0.54). Documented hypercalciuria occurred in 52% of patients in the treatment group, but was not associated with nephrocalcinosis.

Conclusions

Although supplementation with calcium and vitamin D improved 25(OH)D levels significantly, there was no effect on BMC, BMD or relapse rate over a 6-month follow-up. Occurrence of hypercalciuria mandates caution and appropriate monitoring if using such therapy. Appropriate dosage of vitamin D3 remains uncertain and studies examining biologically active vitamin D may provide answers.

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Title: The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome
Authors: Sushmita Banerjee
Surupa Basu
Ananda Sen
Jayati Sengupta
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 11/2017
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3716-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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