Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study |
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| Authors: | David T Selewski Ashton Chen Ibrahim F Shatat Priya Pais Larry A Greenbaum Pavel Geier Raoul D Nelson Stefan G Kiessling Patrick D Brophy Alejandro Quiroga Michael E Seifert Caroline E Straatmann John D Mahan Maria E Ferris Jonathan P Troost Debbie S Gipson |
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| Institution: | 1.Division of Nephrology, Department of Pediatrics and Communicable Diseases,C.S. Mott Children’s Hospital, University of Michigan,Ann Arbor,USA;2.Department of Pediatrics, Section of Pediatric Nephrology,Wake Forest Baptist Health,Winston-Salem,USA;3.Division of Pediatric Nephrology and Hypertension,Sidra Medical and Research Center,Doha,Qatar;4.Medical University of South Carolina,Charleston,USA;5.Department of Pediatric Nephrology, St. John’s Medical College Hospital,St John’s National Academy of Health Sciences,Bangalore,India;6.Emory University and Children’s Healthcare of Atlanta,Atlanta,USA;7.Division of Nephrology, Department of Pediatrics, Children’s Hospital of Eastern Ontario,University of Ottawa,Ottawa,Canada;8.Division of Nephrology, Department of Pediatrics,University of Utah,Salt Lake City,USA;9.Department of Pediatrics,University of Kentucky,Lexington,USA;10.Stead Family Department of Pediatrics, Division of Nephrology,University of Iowa,Iowa City,USA;11.DeVos Children’s Hospital,Grand Rapids,USA;12.Division of Pediatric Nephrology, Department of Pediatrics,Washington University at St. Louis,St. Louis,USA;13.Department of Pediatrics,Southern Illinois University,Springfield,USA;14.Department of Pediatrics,Louisiana State University and Children’s Hospital,New Orleans,USA;15.Nationwide Children’s Hospital,The Ohio State University, College of Medicine,Columbus,USA;16.Pediatric Nephrology, UNC Kidney Center,The University of North Carolina at Chapel Hill,Chapel Hill,USA |
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| Abstract: | BackgroundCross-sectional studies of children with prevalent nephrotic syndrome (NS) have shown 25-vitamin D (25(OH)D) deficiency rates of 20–100 %. Information on 25(OH)D status in incident patients or following remission is limited. This study aimed to assess 25(OH)D status of incident idiopathic NS children at presentation and longitudinally with short-term observation.MethodsMulticenter longitudinal study of children (2–18 years old) from 14 centers across the Midwest Pediatric Nephrology Consortium with incident idiopathic NS. 25(OH)D levels were assessed at diagnosis and 3 months later.ResultsSixty-one children, median age 5 (3, 11) years, completed baseline visit and 51 completed second visit labs. All 61 (100 %) had 25(OH)D?<?20 ng/ml at diagnosis. Twenty-seven (53 %) had 25(OH)D?<?20 ng/ml at follow-up. Fourteen (28 %) children were steroid resistant. Univariate analysis showed that children prescribed vitamin D supplements were less likely to have 25(OH)D deficiency at follow-up (OR 0.2, 95 % CI 0.04, 0.6). Steroid response, age, and season did not predict 25(OH)D deficiency. Multivariable linear regression modeling showed higher 25(OH)D levels at follow-up by 13.2 ng/ml (SE 4.6, p?<?0.01) in children supplemented with vitamin D.ConclusionsIn this incident idiopathic NS cohort, all children at diagnosis had 25(OH)D deficiency and the majority continued to have a deficiency at 2–4 months. Supplemental vitamin D decreased the odds of 25(OH)D deficiency at follow-up, supporting a role for supplementation in incident NS. |
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