VITAMIN D DEFICIENCY IN CHILDREN WITH CHRONIC RENAL DISEASE

Deficiency of the active form of vitamin D calcitriol is determined in the early stages of chronic kidney disease and progresses as the glomerular filtration rate decreases due to a decrease in its synthesis in the proximal tubules. A decrease in calcitriol level is a consequence of chronic kidney disease and at the same time accelerates its progression. This article presents literature data and the results of our own research on the analysis of the relationship between chronic kidney disease and vitamin D provision in children from 1 to 17 years old. Objective was to establish the level of Vitamin D in children with different stages of chronic kidney disease. Between January 2020 and September 2020 we examined 40 children (16 boys and 24 girls). The patients' age ranged from 1 to 17 years inclusive. Vitamin D deficiency was found in 62.5% of children with chronic kidney disease. Vitamin D deficiency was noted in 25% of cases. The prevalence of vitamin D deficiency correlates with a decrease in glomerular filtration rate. Determination of vitamin D level in children with chronic kidney disease is important for timely correction and prevention of further progression of chronic kidney disease. Timely substitution therapy will improve the quality of life of a child with chronic kidney disease and prevent the development of complications.

chronic kidney disease, vitamin D, children, insufficiency, deficiency

1. Витамин D и мочекаменная болезнь / С. Ю. Калинченко, Е. А. Пигарова, Д. А. Гусакова, А. В. Плещева //Consilium Medicum. - 2012. - Т. 14, №12. - С. 97-102.

2. Кальцидиол у детей с хронической болезнью почек 2-5 стадий /Э. К. Петросян, М. С. Молчанова, Т. Е. Панкратенко //Нефрология. - 2018. - V. 22. - P. 58-64.

3. Мальцев С. В. Метаболизм витамина d и пути реализации его основных функций /С. B. Мальцев, Г. Ш. Мансурова //Практическая медицина. - 2014. - №9 (85). - С. 12-18.

4. Сафина А. И. Клинико-патогенетическая роль бактериальных и вирусных инфекций в развитии и прогрессировании пиелонефрита у детей: Автореф. дис..д-ра мед. наук. - Н. Новгород, 2005. - 47 с.

5. Сафина А. И. Острая почечная недостаточность у новорожденных /А. И. Сафина, М. А. Даминова //Практич. медицина. - 2011. -№5 (53). - С. 43-50.

6. Смирнов А. В. Роль витамина d в замедлении прогрессирования хронической болезни почек /А. В. Смирнов, М. М. Волков // Нефрология. - 2008. - №4. - С. 48-52.

7. Anemia and risk for cognitive decline in chronic kidney disease /T. M. Kurella, E. Vittinghoff, J. Yang et al. //BMC Nephrol. - 2016. - №17. - 13 p.

8. Becherucci F. Chronic kidney disease in children //Clinical kidney journal. - 2016. - №9. - C. 583-591.

9. Chesney R. W. Interactions of vitamin D and the proximal tubule //Pediatr. Nephrol. - 2016. - V. 31. - P. 7-14.

10. Damasiewicz M. Vitamina D therapy in chronic kidney disease: back to the future? /M. Damasiewicz, P. G. Kerr, K. R. Polkinghorne // Clin. Nephrol. - 2015. - V. 84. - P. 65-74.

11. Diagnosis and management of iron deficiency in CKD: a summary of the NICE guideline recommendations and their rationale /L. E. Ratcliffe, W. Thomas, J. Glen et al. //Am. J. Kidney Dis. - 2016. - №67. - P. 548-558.

12. Dibas B. I. Vitamin D status of children receiving chronic dialysis /B. I. Dibas, B. A. Warady /Pediatr. Nephrol. - 2012. - V. 27(10). - P. 1967-1973.

13. Ding W. Impact of obesity on kidney funcion and blood pressure in children /W. Ding, W. W. Cheung, R. H. Mak //World J. Nephrol. -2015. - №4. - P. 223-229.

14. Dummer P. D. APOL1 kidney disease risk variants: an evolving landscape /P. D. Dummer, S. Limou, A. Z. Rosenberg et al. //Semin. Nephrol. - 2015. - №35. - P. 222-236.

15. Gat-Yablonski G. Nutritionally induced catch-up growth /G. Gat-Yablonski, M. Phillip // Nutrients. - 2015. - №7. - P. 517-551.

16. Heterogeneous genetic alterations in sporadic nephrotic syndrome associate with resistance to immunosuppression /S. Giglio, A. Provenzano, B. Mazzinghi et al. //J. Am. Soc. Nephrol. - 2015. - №26. - P. 230-236.

17. Hipovitaminosis D en pacientes pediatricos en terapia de sustitucion renal /A. Delucchi, C. Alarcon, F. Cano et al. //Rev. Med. Chil. - 2011. - V. 139 (3). - P. 334-339.

18. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. - Washington, DC: National Academy Press, 2010. - 45 p.

19. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease //Kidney Int. Suppl. - 2013. - V. 3. - P. 120-124.

20. KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: 2008 update // Am. J. Kidney. - 2009. - V. 53. - P. 66-69.

21. KDOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Children with Chronic Kidney Disease //Am. J. Kidney. - 2005. -V. 46. - P. 1-122.

22. Mansbach J. M.Serum 25-hydroxy-vitamin D levels among US children aged 1 to 11 years: do children need more vitamin D? /J. M. Mansbach, A. A. Ginde, C. A. Camargo Jr. //Pediatrics. - 2009. - V. 124(5). - P. 1404-1410.

23. Mithal A. Treatment of vitamin D deficiency //Endocrine case management ICE/ENDO. - 2014. - V. 17. - P. 37-39.

24. Practical guidelines for the supplementation of vitamin D and the treatment of defi cits in Central Europe - recommended vitamin D intakes in the general population and groups at risk of vitamin D defi ciency /P. Piudowski, E. Karczmarewicz, M. Bayer et al. //Endokrynologia Polska. - 2013. - V. 64(4). - P. 319-327.

25. Prevalence of 25(OH) vitamin D insuffi ciency and defi ciency in pediatric patients on chronic dialysis /H. Y. Cho, H. S. Hyun, H. G. Kang et. al. //Perit. Dial. Int. - 2013. - V. 33(4). - P. 398-404.

26. Rees L. The demise of calcium-based phosphate binders - is this appropriate for children? /L. Rees, R. Shroff //Pediatr. Nephrol. - 2015. - №30. - P. 2061-2071.

27. Saintonge S. Implications of a new definition of vitamin D deficiency in a multiracial US adolescent population: the National Health and Nutrition Examination Survey III /S. Saintonge, H. Bang, L. M. Gerber //Pediatrics. -2009. - V. 123(3). - P. 797-803.

28. The metabolic syndrome in children and adolescents as a complex risk factor for cardiovascular disease /A. I. Safina, I. Ja. Lutfullin, Je. A. Gajnullina, A. V. Galeeva //Practical medicine. - 2010. - V. 5 (44). - P. 61-65.

29. Translational research in nephrology: chronic kidney disease prevention and public health /K. Bruck, V. S. Stel, S. Fraser et al. //Clin. Kidney J. - 2015. - №8. - P. 647-655.

30. US Renal Data System 2014 annual data report: epidemiology of kidney disease in the United States /r. Saran, Y. Li, B. Robinson et al. // Am. J. Kidney Dis. - 2015. - №66. - P. 1-16

31. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality - a review of recent evidence /P. Pludowski, M. F. Holick, S. Pilz et al. //Autoimmun. Rev. - 2013. - V. 12 (10). - P. 976-989.

32. Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease /P. Hari, N. Gupta, S. Hari et al. //Pediatr. Nephrol. - 2010. - V. 25 (12). - P. 2483-2488.

33. Vivante A. Exploring the genetic basis of early-onset chronic kidney disease /A. Vivante, F. Hildebrandt //Nat. Rev. Nephrol. - 2016. -№12. - P. 133-146.