Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study

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

doi:10.1007/s00467-015-3236-x

Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study

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

Pediatrics

Research output: Contribution to journal › Article › peer-review

29 Scopus citations

Abstract

Background: Cross-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. Methods: Multicenter 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. Results: Sixty-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. Conclusions: In 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.

Original language	English
Pages (from-to)	465-472
Number of pages	8
Journal	Pediatric Nephrology
Volume	31
Issue number	3
DOIs	https://doi.org/10.1007/s00467-015-3236-x
State	Published - Mar 1 2016

Bibliographical note

Publisher Copyright:
© 2015, IPNA.

Funding

The investigators are indebted to the children and families who graciously participated in this study. This work was supported by a grant from the Renal Research Institute. M.E.S. was supported by the Washington University Institute of Clinical and Translational Sciences grants UL1 TR000448 and KL2 TR000450 from NIH/NCATS, and L40 DK099748 from NIH/NIDDK. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Funders	Funder number
California Institute of Renal Research
National Institutes of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases
National Center for Advancing Translational Sciences (NCATS)	L40 DK099748, UL1TR000448
Indiana Clinical and Translational Sciences Institute	KL2 TR000450, UL1 TR000448

Keywords

25(OH)D deficiency
Children
Nephrotic syndrome
Pediatric
Vitamin D

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Nephrology

Access to Document

10.1007/s00467-015-3236-x

Cite this

Selewski, D. T., Chen, A., Shatat, I. F., Pais, P., Greenbaum, L. A., Geier, P., Nelson, R. D., Kiessling, S. G., Brophy, P. D., Quiroga, A., Seifert, M. E., Straatmann, C. E., Mahan, J. D., Ferris, M. E., Troost, J. P., & Gipson, D. S. (2016). Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study. Pediatric Nephrology, 31(3), 465-472. https://doi.org/10.1007/s00467-015-3236-x

@article{e68b97a5ce15491d81fb9b9291f4385e,

title = "Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study",

abstract = "Background: Cross-sectional studies of children with prevalent nephrotic syndrome (NS) have shown 25-vitamin D (25(OH)D) deficiency rates of 20{\textendash}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. Methods: Multicenter longitudinal study of children (2{\textendash}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. Results: Sixty-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. Conclusions: In this incident idiopathic NS cohort, all children at diagnosis had 25(OH)D deficiency and the majority continued to have a deficiency at 2{\textendash}4 months. Supplemental vitamin D decreased the odds of 25(OH)D deficiency at follow-up, supporting a role for supplementation in incident NS.",

keywords = "25(OH)D deficiency, Children, Nephrotic syndrome, Pediatric, Vitamin D",

author = "Selewski, \{David T.\} and Ashton Chen and Shatat, \{Ibrahim F.\} and Priya Pais and Greenbaum, \{Larry A.\} and Pavel Geier and Nelson, \{Raoul D.\} and Kiessling, \{Stefan G.\} and Brophy, \{Patrick D.\} and Alejandro Quiroga and Seifert, \{Michael E.\} and Straatmann, \{Caroline E.\} and Mahan, \{John D.\} and Ferris, \{Maria E.\} and Troost, \{Jonathan P.\} and Gipson, \{Debbie S.\}",

note = "Publisher Copyright: {\textcopyright} 2015, IPNA.",

year = "2016",

month = mar,

day = "1",

doi = "10.1007/s00467-015-3236-x",

language = "English",

volume = "31",

pages = "465--472",

number = "3",

}

Selewski, DT, Chen, A, Shatat, IF, Pais, P, Greenbaum, LA, Geier, P, Nelson, RD, Kiessling, SG, Brophy, PD, Quiroga, A, Seifert, ME, Straatmann, CE, Mahan, JD, Ferris, ME, Troost, JP & Gipson, DS 2016, 'Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study', Pediatric Nephrology, vol. 31, no. 3, pp. 465-472. https://doi.org/10.1007/s00467-015-3236-x

TY - JOUR

T1 - Vitamin D in incident nephrotic syndrome

T2 - a Midwest Pediatric Nephrology Consortium study

AU - Selewski, David T.

AU - Chen, Ashton

AU - Shatat, Ibrahim F.

AU - Pais, Priya

AU - Greenbaum, Larry A.

AU - Geier, Pavel

AU - Nelson, Raoul D.

AU - Kiessling, Stefan G.

AU - Brophy, Patrick D.

AU - Quiroga, Alejandro

AU - Seifert, Michael E.

AU - Straatmann, Caroline E.

AU - Mahan, John D.

AU - Ferris, Maria E.

AU - Troost, Jonathan P.

AU - Gipson, Debbie S.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: Cross-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. Methods: Multicenter 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. Results: Sixty-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. Conclusions: In 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.

AB - Background: Cross-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. Methods: Multicenter 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. Results: Sixty-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. Conclusions: In 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.

KW - 25(OH)D deficiency

KW - Children

KW - Nephrotic syndrome

KW - Pediatric

KW - Vitamin D

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U2 - 10.1007/s00467-015-3236-x

DO - 10.1007/s00467-015-3236-x

M3 - Article

C2 - 26498119

AN - SCOPUS:84958947415

SN - 0931-041X

VL - 31

SP - 465

EP - 472

JO - Pediatric Nephrology

JF - Pediatric Nephrology

IS - 3

ER -

Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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