title: A Practical Approach to Vitamin D Deficiency and Rickets.
abstract: Rickets is a condition in which there is failure of the normal mineralisation (osteomalacia) of growing bone. Whilst osteomalacia may be present in adults, rickets cannot occur. It is generally caused by a lack of mineral supply, which can either occur as a result of the deficiency of calcium (calciopaenic rickets, now known as parathyroid hormone-dependent rickets) or of phosphate (phosphopaenic rickets, now called FGF23-dependent rickets). Renal disorders may also interfere with the process of mineralisation and cause rickets. Only parathyroid hormone-dependent rickets and distal renal tubular disorders will be discussed in this chapter. The most common cause of rickets is still vitamin D deficiency, which is also responsible for other problems. Disorders of vitamin D metabolism or responsiveness may also cause similar issues. Distal renal tubular acidosis may also be caused by a variety of metabolic errors similar to those of osteoclasts. One form of distal renal tubular acidosis also causes a type of osteopetrosis. This chapter describes these conditions in detail and sets out a logical approach for treatment.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Allgrove
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Shaw
mesh_terms: D000141:Acidosis, Renal Tubular / Q000175:diagnosis* / Q000378:metabolism; D000328:Adult; D002118:Calcium / Q000378:metabolism; D002648:Child; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D010018:Osteomalacia / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D010281:Parathyroid Hormone / Q000378:metabolism; D012279:Rickets / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D063730:Rickets, Hypophosphatemic / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D014808:Vitamin D Deficiency / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy
chemical_list: C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002118:Calcium