Vitamin D deficiency and parathyroid hormone levels following renal transplantation in children.
The objectives were to determine the prevalence of vitamin D deficiency [25(OH)D < 10 ng/ml] in pediatric renal transplant (RTx) recipients, compared with controls and identify correlates of changes in 25(OH)D and intact parathyroid hormone (iPTH) levels following transplantation. Serum 25(OH)D, 1,25(OH)(2)D, and iPTH were measured once in 275 healthy controls and at transplantation, and 3 and 12 months posttransplantation in 58 RTx recipients. Multivariate logistic regression models determined the odds ratio (OR) of vitamin D deficiency in RTx recipients vs. controls adjusted for age, sex, race, and season. Generalized estimating equations were used to assess changes following transplantation. At transplantation, 22% of nonblack and 27% of black RTx recipients were vitamin D deficient. The adjusted OR of vitamin D deficiency was greater in RTx recipients (p < 0.001) compared with controls; however, the transplant association was greater in nonblack vs. black individuals (interaction p = 0.02). Overall, 25(OH)D levels did not change significantly following transplantation. Younger age (p < 0.01), nonblack race (p < 0.001), visits in nonwinter months (p < 0.001), and supplementation with ≥400 IU/day ergo/cholecalciferol (p < 0.001) were associated with increases (or lesser declines) in 25(OH)D following transplantation. Increases in 25(OH)D levels (p < 0.001) and vitamin D supplementation (p < 0.01) were associated with greater reductions in iPTH levels following transplantation, independent of 1,25(OH)(2)D levels.
Tuchman
Shamir
S
Children's National Medical Center, Washington, DC, USA.
Kalkwarf
Heidi J
HJ
Zemel
Babette S
BS
Shults
Justine
J
Wetzsteon
Rachel J
RJ
Foerster
Debbie
D
Strife
C Frederic
CF
Leonard
Mary B
MB
D000293:Adolescent; D001741:Black or African American; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood* / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D009820:Ohio; D010281:Parathyroid Hormone / Q000097:blood*; D015143:Philadelphia; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D