Prevalence and correlates of 25-hydroxyvitamin D deficiency in the Chronic Kidney Disease in Children (CKiD) cohort

Juhi Kumar, Kelly McDermott, Alison G. Abraham, Lisa Aronson Friedman, Valerie L. Johnson, Frederick J. Kaskel, Susan L. Furth, Bradley A. Warady, Anthony A. Portale, Michal L. Melamed

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)121-129
Number of pages9
JournalPediatric Nephrology
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2016

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Keywords

  • Chronic renal disease
  • Fibroblast growth factor 23
  • Hyperparathyroidism
  • Mineral metabolism
  • Pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Kumar, J., McDermott, K., Abraham, A. G., Friedman, L. A., Johnson, V. L., Kaskel, F. J., Furth, S. L., Warady, B. A., Portale, A. A., & Melamed, M. L. (2016). Prevalence and correlates of 25-hydroxyvitamin D deficiency in the Chronic Kidney Disease in Children (CKiD) cohort. Pediatric Nephrology, 31(1), 121-129. https://doi.org/10.1007/s00467-015-3190-7