Vitamin D status of children receiving chronic dialysis

Patients receiving chronic dialysis therapy are presumed to be at risk for 25(OH) D₃ deficiency, but little information is available on its prevalence, manifestations of deficiency, and the impact of ergocalciferol supplementation.

A single-center, retrospective study of 51 prevalent pediatric patients on hemodialysis or peritoneal dialysis was conducted to address these issues.

Forty of 51 (78.4 %) patients had low (<30 ng/ml) 25(OH) D₃ levels. Of these, 2 % had values < 5 ng/ml, 41.2 % 5–15 ng/ml, and 35.3 % 16–30 ng/ml. Age >12 years, non-Caucasian race and > 12-month duration of dialysis were significantly associated with low 25(OH) D₃ levels (p = 0.006, p = 0.05, and p = 0.04, respectively). Twenty-three of the 40 patients deficient in 25(OH) D₃ received repletion therapy with ergocalciferol and had a follow-up level at an average of 2 months following completion of a single course of therapy; 14 (60 %) of the levels were normal. Mean baseline intact parathyroid hormone (iPTH) for patients with 25(OH) D₃ levels ≤ 30 was 478.68 ± 474.01 pg/ml and treatment with ergocalciferol was not associated with a significant decrease in the mean iPTH value (p = 0.45).

We conclude that low 25(OH) D₃ levels are common in pediatric patients receiving dialysis and require attention in accordance with current practice guidelines.