TY - JOUR
T1 - Prevalence and correlates of 25-hydroxyvitamin D deficiency in the Chronic Kidney Disease in Children (CKiD) cohort
AU - Kumar, Juhi
AU - McDermott, Kelly
AU - Abraham, Alison G.
AU - Friedman, Lisa Aronson
AU - Johnson, Valerie L.
AU - Kaskel, Frederick J.
AU - Furth, Susan L.
AU - Warady, Bradley A.
AU - Portale, Anthony A.
AU - Melamed, Michal L.
N1 - Funding Information:
The CKiD study is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Heart, Lung, and Blood Institute (U01-DK66143, U01-DK66174, U01-DK82194, U01-DK66116). Data in this manuscript were collected by the CKiD prospective cohort study with clinical coordinating centers (principal investigators) at Children’s Mercy Hospital and the University of Missouri-Kansas City (Bradley Warady), Children’s Hospital of Philadelphia (Susan Furth), Central Biochemistry Laboratory (George Schwartz) at the University of Rochester Medical Center, and the data coordinating center (Alvaro Muñoz) at the Johns Hopkins Bloomberg School of Public Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, and approval of the manuscript.
Funding Information:
This project was supported by NIH/NIDDK Grants K23 DK084339 (to J.K.) and R01-DK084978 (to A.A.P.). M.L.M. is supported by K23 DK078774, ASN Career Development grant and R01 DK087783.
Publisher Copyright:
© 2015, IPNA.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background: Vitamin D plays an important role in the mineral and bone disorder seen in chronic kidney disease (CKD). Deficiency of 25-hydroxyvitamin D (25OHD) is highly prevalent in the adult CKD population. Methods: The prevalence and determinants of 25OHD deficiency (defined as a level <20 ng/ml) were examined longitudinally in 506 children in the CKiD cohort. Predictors of secondary hyperparathyroidism and the determinants of 1,25-dihydroxyvitamin D (1,25(OH)2D) levels were also evaluated. Results: Deficiency of 25OHD was observed in 28 % of the cohort at enrollment. Significant predictors of 25OHD deficiency were older age, non-white race, higher body mass index, assessment during winter, less often than daily milk intake, non-use of nutritional vitamin D supplement and proteinuria. Lower values of glomerular filtration rate (GFR), serum 25OHD, calcium and higher levels of FGF23 were significant determinants of secondary hyperparathyroidism. Lower GFR, low serum 25OHD, nephrotic-range proteinuria, and high FGF23 levels were significant determinants of serum 1,25(OH)2 D levels. Conclusions: Deficiency of 25OHD is prevalent in children with CKD and is associated with potentially modifiable risk factors such as milk intake, nutritional vitamin D supplement use, and proteinuria. 25OHD deficiency is a risk factor for secondary hyperparathyroidism and decreased serum 1,25(OH)2D in children with CKD.
AB - Background: Vitamin D plays an important role in the mineral and bone disorder seen in chronic kidney disease (CKD). Deficiency of 25-hydroxyvitamin D (25OHD) is highly prevalent in the adult CKD population. Methods: The prevalence and determinants of 25OHD deficiency (defined as a level <20 ng/ml) were examined longitudinally in 506 children in the CKiD cohort. Predictors of secondary hyperparathyroidism and the determinants of 1,25-dihydroxyvitamin D (1,25(OH)2D) levels were also evaluated. Results: Deficiency of 25OHD was observed in 28 % of the cohort at enrollment. Significant predictors of 25OHD deficiency were older age, non-white race, higher body mass index, assessment during winter, less often than daily milk intake, non-use of nutritional vitamin D supplement and proteinuria. Lower values of glomerular filtration rate (GFR), serum 25OHD, calcium and higher levels of FGF23 were significant determinants of secondary hyperparathyroidism. Lower GFR, low serum 25OHD, nephrotic-range proteinuria, and high FGF23 levels were significant determinants of serum 1,25(OH)2 D levels. Conclusions: Deficiency of 25OHD is prevalent in children with CKD and is associated with potentially modifiable risk factors such as milk intake, nutritional vitamin D supplement use, and proteinuria. 25OHD deficiency is a risk factor for secondary hyperparathyroidism and decreased serum 1,25(OH)2D in children with CKD.
KW - Chronic renal disease
KW - Fibroblast growth factor 23
KW - Hyperparathyroidism
KW - Mineral metabolism
KW - Pediatric
UR - http://www.scopus.com/inward/record.url?scp=84947487987&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84947487987&partnerID=8YFLogxK
U2 - 10.1007/s00467-015-3190-7
DO - 10.1007/s00467-015-3190-7
M3 - Article
C2 - 26307635
AN - SCOPUS:84947487987
SN - 0931-041X
VL - 31
SP - 121
EP - 129
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 1
ER -