title: Vitamin D status in children with chronic kidney disease.
abstract: BACKGROUND
  The role of vitamin D status in patients with renal insufficiency and its relation to dietary intake and parathyroid hormone (PTH) secretion is of utmost interest given the morbidity and mortality associated with the disordered mineral metabolism seen in chronic kidney disease (CKD).
  
  
  METHODS
  We conducted a cross-sectional study of 100 pediatric patients with a diagnosis of CKD stage 1-5 at Children's Hospital Boston, measuring blood levels of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], and parathyroid hormone and obtaining data on nutrient intake and other variables related to vitamin D status.
  
  
  RESULTS
  Subjects ranged in age from 6 months to 18 years, and 60 were male, 40 female. Of the 100 patients, 16 % were deficient in 25(OH)D (≤ 20 ng/mL) and another 24 % were insufficient (≤ 30 ng/mL), with 40 % in the suboptimal range. Serum 25(OH)D and dietary vitamin D intake were not correlated.
  
  
  CONCLUSIONS
  We found a high prevalence of hyperparathyroidism in early-stage CKD and a significant relationship between 25(OH)D and PTH regardless of calcitriol level. Our study results support the suggestion that optimization of vitamin D levels may provide additional benefit in preventing or improving hyperparathyroidism in patients with early CKD and likely remains important as an adjunctive therapy in children with advanced CKD.
authors.affiliation: Department of Pediatrics, Children's Hospital Boston, Boston, MA, USA. deborah.stein@childrens.harvard.edu
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Stein
authors.forename: Henry A
authors.initials: HA
authors.lastname: Feldman
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Gordon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000453:epidemiology; D007223:Infant; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D