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Native vs. active vitamin D in children with chronic kidney disease: a cross-over study

Happy Sawires1, Fatina Fadel2, Ahmed Hussein2

  • 1Pediatric Nephrology Department, Cairo University, 5 El-Lithy Street El-Maadi El-Gedida, Cairo, 11435, Egypt. happy7_kd@yahoo.com.

Pediatric Nephrology (Berlin, Germany)
|August 27, 2020
PubMed

Insights

Native vitamin D and alfacalcidol showed similar effectiveness in managing parathyroid hormone (PTH) and vitamin D levels in children with chronic kidney disease (CKD). Both treatments did not significantly alter calcium or phosphorus levels.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pediatrics

Background:

  • The use of vitamin D analogs in chronic kidney disease (CKD) management remains debated.
  • Optimal vitamin D therapy for pediatric pre-dialysis CKD patients requires further investigation.

Purpose of the Study:

  • To compare the efficacy of native vitamin D versus active vitamin D (alfacalcidol) in pre-dialysis pediatric CKD patients.
  • To evaluate the impact of these vitamin D forms on calcium, phosphorus, and parathyroid hormone levels.

Main Methods:

  • A prospective cross-over study involving 30 pre-dialysis children with CKD.
  • Patients received either native cholecalciferol or alfacalcidol for 3 months, followed by a 1-month washout period and then the alternative treatment for 3 months.
  • Serum calcium, phosphorus, alkaline phosphatase, PTH, and 25(OH)D3 levels were monitored.

Main Results:

  • Both native vitamin D and alfacalcidol significantly increased serum 25(OH)D3 levels in both treatment periods.
  • No significant differences were observed between the two groups in changes in serum calcium, phosphorus, or PTH levels.
  • Both vitamin D forms demonstrated comparable effects on key biochemical markers.

Conclusions:

  • Alfacalcidol and native vitamin D are equally effective in reducing PTH and increasing 25(OH)D3 in pre-dialysis pediatric CKD patients.
  • Neither form showed a significant advantage in altering serum calcium or phosphorus levels.
  • The findings suggest comparable therapeutic outcomes for both native and active vitamin D in this patient population.
Abstract

Keywords:
25(OH)D3AlfacalcidolChildrenCholecalciferolParathyroid hormonePre-dialysis

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