title: Therapy strategies in vitamin D deficiency with or without rickets: efficiency of low-dose stoss therapy.
abstract: BACKGROUND
  Vitamin D deficiency can be treated with daily vitamin D supplementation for several weeks or single-day high-dose vitamin D therapy (stoss therapy). However, there are few studies comparing efficiency and side effects of these two treatment models.
  
  
  OBJECTIVE
  We aimed to compare the efficiency and side effects of low-dose stoss therapy and lower-dose daily vitamin D supplementation in children with vitamin D deficiency.
  
  
  METHODS
  Our subjects were 42 patients with ages between 5 months and 3 years with diagnosed vitamin D deficiency. All children had 25-hydroxyvitamin D level lower than 20 ng/mL. Serum biochemical markers and spot urine calcium/creatinine (Ca/Cr) ratio were measured before and after the therapy. Twenty-one patients were treated with stoss therapy (150,000 U/single-dose oral vitamin D3), and 21 patients were treated with daily high-dose vitamin D3 therapy (2000 U/day vitamin D, 6 weeks). Renal ultrasound was performed for both groups of patients after 1 month.
  
  
  RESULTS
  Biochemical parameters and Ca/Cr ratio at the end of therapy did not differ in each groups. However, vitamin D levels at the end of stoss therapy were significantly increased compared with daily lower-dose vitamin D therapy group (p<0.001). Nephrocalcinosis or renal stone was not detected by renal ultrasound.
  
  
  CONCLUSIONS
  In both groups, hypocalcemia was not detected during the therapy. There was no evidence about the increasing risk of hypercalciuria in low-stoss therapy. Higher vitamin D levels were obtained in low-stoss therapy group.
authors.affiliation: Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey. dr.emeltorun@gmail.com
authors.forename: Torun
authors.initials: T
authors.lastname: Emel
authors.forename: Demir Ayşegül
authors.initials: DA
authors.lastname: Doğan
authors.forename: Gönüllü
authors.initials: G
authors.lastname: Erdem
authors.forename: Oktem
authors.initials: O
authors.lastname: Faruk
mesh_terms: D002118:Calcium / Q000097:blood / Q000652:urine; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D012279:Rickets / Q000188:drug therapy* / Q000378:metabolism; D014463:Ultrasonography; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D014807:Vitamin D; D002118:Calcium