396 risk of renal damage from large dose vitamin d therapy

396 risk of renal damage from large dose vitamin d therapy

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ABSTRACT Vit D in high dosage is a well established treatment of hypoparathyroidism (HP),pseudohypoparathyroidism (PHP), vit D dependency rickets (VDDR) and hypophosphatemic rickets (HPR). The few systematic assessments of its long-term effects on renal status have been in pts with vit D refractory rickets; some of these pts showed histological damage or functional impairment. We studied 26 pts (10 HP, 2 PHP, 6 VDDR, and 8 HPR)who received vit D or its metabolites for 1-21 (mean 11) yrs. Therapy was supervised according to a standard protocol at a special pediatric clinic, usually from the time of diagnosis. Plasma Ca was determined 2-monthly for pts on vit D or 25-OHD3 and monthly for those on 1,25-(OH)2D3. Treatment was interrupted if plasma Ca exceeded 10.5 mg/dl and resumed with 80% of the previous dose once normocalcemia returned.The pts were normocalcemic when the studies were carried out. 7/26 had diminished GFR, 5/25 concentration defect, 1/14 acidification defect. Renal histology showed tubulo-interstitial nephritis and/or calcium deposits in 17/26 pts Eight of the pts with histological abnormalities had functional impairment; however, 2 of the 9 pts with normal histology also had functional impairment. The incidence of histological abnormalities was correlated with the duration of hypercalcemia and with diagnosis, being lowest in VDDR. These studies indicate that pts receiving large dose vit D therapy are at a high risk of sustaining histological and functional damage of the kidney. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Dept Paed., Univ of Toronto, J Curtis, A C Hsu, R Baumal, C P Ranee, B Steele, S W Kooh & D Fraser * Research Institute, The Hospital for Sick Children, Toronto, Canada J Curtis, A C Hsu, R Baumal, C P Ranee, B Steele, S W Kooh & D Fraser Authors * J Curtis View author publications You can also search for this author inPubMed Google Scholar * A C Hsu View author publications You can also search for this author inPubMed Google Scholar * R Baumal View author publications You can also search for this author inPubMed Google Scholar * C P Ranee View author publications You can also search for this author inPubMed Google Scholar * B Steele View author publications You can also search for this author inPubMed Google Scholar * S W Kooh View author publications You can also search for this author inPubMed Google Scholar * D Fraser View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Curtis, J., Hsu, A., Baumal, R. _et al._ 396 RISK OF RENAL DAMAGE FROM LARGE DOSE VITAMIN D THERAPY. _Pediatr Res_ 15 (Suppl 4), 506 (1981). https://doi.org/10.1203/00006450-198104001-00407 Download citation * Issue Date: 01 April 1981 * DOI: https://doi.org/10.1203/00006450-198104001-00407 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative

ABSTRACT Vit D in high dosage is a well established treatment of hypoparathyroidism (HP),pseudohypoparathyroidism (PHP), vit D dependency rickets (VDDR) and hypophosphatemic rickets (HPR).


The few systematic assessments of its long-term effects on renal status have been in pts with vit D refractory rickets; some of these pts showed histological damage or functional impairment.


We studied 26 pts (10 HP, 2 PHP, 6 VDDR, and 8 HPR)who received vit D or its metabolites for 1-21 (mean 11) yrs. Therapy was supervised according to a standard protocol at a special


pediatric clinic, usually from the time of diagnosis. Plasma Ca was determined 2-monthly for pts on vit D or 25-OHD3 and monthly for those on 1,25-(OH)2D3. Treatment was interrupted if


plasma Ca exceeded 10.5 mg/dl and resumed with 80% of the previous dose once normocalcemia returned.The pts were normocalcemic when the studies were carried out. 7/26 had diminished GFR,


5/25 concentration defect, 1/14 acidification defect. Renal histology showed tubulo-interstitial nephritis and/or calcium deposits in 17/26 pts Eight of the pts with histological


abnormalities had functional impairment; however, 2 of the 9 pts with normal histology also had functional impairment. The incidence of histological abnormalities was correlated with the


duration of hypercalcemia and with diagnosis, being lowest in VDDR. These studies indicate that pts receiving large dose vit D therapy are at a high risk of sustaining histological and


functional damage of the kidney. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Dept Paed., Univ of Toronto, J Curtis, A C Hsu, R Baumal, C P Ranee, B Steele, S W Kooh & D


Fraser * Research Institute, The Hospital for Sick Children, Toronto, Canada J Curtis, A C Hsu, R Baumal, C P Ranee, B Steele, S W Kooh & D Fraser Authors * J Curtis View author


publications You can also search for this author inPubMed Google Scholar * A C Hsu View author publications You can also search for this author inPubMed Google Scholar * R Baumal View author


publications You can also search for this author inPubMed Google Scholar * C P Ranee View author publications You can also search for this author inPubMed Google Scholar * B Steele View


author publications You can also search for this author inPubMed Google Scholar * S W Kooh View author publications You can also search for this author inPubMed Google Scholar * D Fraser


View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Curtis, J., Hsu, A.,


Baumal, R. _et al._ 396 RISK OF RENAL DAMAGE FROM LARGE DOSE VITAMIN D THERAPY. _Pediatr Res_ 15 (Suppl 4), 506 (1981). https://doi.org/10.1203/00006450-198104001-00407 Download citation *


Issue Date: 01 April 1981 * DOI: https://doi.org/10.1203/00006450-198104001-00407 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable


link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative