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Is high-dose cholecalciferol justified in children with chronic kidney disease who failed low-dose maintenance

Jameela Abdulaziz Kari1, Osama T Baghdadi, Sherif El-Desoky

  • 1Department of Pediatrics, King Abdulaziz University, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia. jkari@doctors.org.uk

Pediatric Nephrology (Berlin, Germany)
|January 23, 2013
PubMed

Insights

A single high-dose intramuscular vitamin D3 injection significantly improved vitamin D3 and intact parathyroid hormone (iPTH) levels in children with chronic kidney disease (CKD). This treatment offers a promising approach for managing vitamin D status in pediatric CKD patients.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Nutritional Science

Background:

  • Children with chronic kidney disease (CKD) often experience vitamin D insufficiency or deficiency.
  • Vitamin D deficiency can exacerbate secondary hyperparathyroidism in pediatric CKD patients.
  • Intact parathyroid hormone (iPTH) levels are a key indicator of mineral and bone disorders in CKD.

Purpose of the Study:

  • To evaluate the efficacy of a single, high-dose intramuscular cholecalciferol (vitamin D3) injection.
  • To assess the impact on vitamin D3 and intact parathyroid hormone (iPTH) levels in children with CKD.
  • To determine the changes in key biochemical markers related to mineral metabolism.

Main Methods:

  • Prospective, uncontrolled study involving 19 children with CKD and vitamin D insufficiency/deficiency.
  • Administration of a single intramuscular dose of 300,000 IU vitamin D3.
  • Measurement of serum vitamin D3, iPTH, calcium, phosphate, alkaline phosphatase (ALP), and creatinine at baseline, 1 month, and 3 months post-treatment.

Main Results:

  • Vitamin D3 levels significantly increased at 3 months post-treatment compared to baseline (p < 0.001).
  • Intact parathyroid hormone (iPTH) levels showed a significant decrease at 3 months (p = 0.01).
  • No significant changes were observed in calcium, phosphate, ALP, or creatinine levels.

Conclusions:

  • A single intramuscular dose of 300,000 IU vitamin D3 is effective in improving vitamin D3 status in children with CKD.
  • This high-dose vitamin D3 regimen leads to a significant reduction in iPTH levels.
  • Intramuscular vitamin D3 administration presents a viable therapeutic option for managing vitamin D deficiency and secondary hyperparathyroidism in pediatric CKD.
Abstract

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