TY - JOUR
T1 - Clinical practice recommendations for native vitamin D therapy in children with chronic kidney disease Stages 2-5 and on dialysis
AU - European Society for Paediatric Nephrology Chronic Kidney Disease Mineral and Bone Disorders and Dialysis Working Groups
AU - Shroff, Rukshana
AU - Wan, Mandy
AU - Nagler, Evi V
AU - Bakkaloglu, Sevcan
AU - Fischer, Dagmar-C
AU - Bishop, Nicholas
AU - Cozzolino, Mario
AU - Bacchetta, Justine
AU - Edefonti, Alberto
AU - Stefanidis, Constantinos J
AU - Vande Walle, Johan
AU - Haffner, Dieter
AU - Klaus, Günter
AU - Schmitt, Claus Peter
N1 - © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Vitamin D deficiency is widely prevalent and often severe in children and adults with chronic kidney disease (CKD). Although native vitamin D {25-hydroxyvitamin D [25(OH)D]} is thought to have pleiotropic effects on many organ systems, its skeletal effects have been most widely studied. The 25(OH)D deficiency is causally linked with rickets and fractures in healthy children and those with CKD, contributing to the CKD-mineral and bone disorder (MBD) complex. There are few studies to provide evidence for vitamin D therapy or guidelines for its use in CKD. A core working group (WG) of the European Society for Paediatric Nephrology (ESPN) CKD-MBD and Dialysis WGs have developed recommendations for the evaluation, treatment and prevention of vitamin D deficiency in children with CKD. We present clinical practice recommendations for the use of ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) in children with CKD Stages 2-5 and on dialysis. A parallel document addresses treatment recommendations for active vitamin D analogue therapy. The WG has performed an extensive literature review to include meta-analyses and randomized controlled trials in healthy children as well as children and adults with CKD, and prospective observational studies in children with CKD. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system has been used to develop and grade the recommendations. In the absence of applicable study data, the opinion of experts from the ESPN CKD-MBD and Dialysis WGs is provided, but clearly GRADE-ed as such and must be carefully considered by the treating physician, and adapted to individual patient needs as appropriate.
AB - Vitamin D deficiency is widely prevalent and often severe in children and adults with chronic kidney disease (CKD). Although native vitamin D {25-hydroxyvitamin D [25(OH)D]} is thought to have pleiotropic effects on many organ systems, its skeletal effects have been most widely studied. The 25(OH)D deficiency is causally linked with rickets and fractures in healthy children and those with CKD, contributing to the CKD-mineral and bone disorder (MBD) complex. There are few studies to provide evidence for vitamin D therapy or guidelines for its use in CKD. A core working group (WG) of the European Society for Paediatric Nephrology (ESPN) CKD-MBD and Dialysis WGs have developed recommendations for the evaluation, treatment and prevention of vitamin D deficiency in children with CKD. We present clinical practice recommendations for the use of ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) in children with CKD Stages 2-5 and on dialysis. A parallel document addresses treatment recommendations for active vitamin D analogue therapy. The WG has performed an extensive literature review to include meta-analyses and randomized controlled trials in healthy children as well as children and adults with CKD, and prospective observational studies in children with CKD. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system has been used to develop and grade the recommendations. In the absence of applicable study data, the opinion of experts from the ESPN CKD-MBD and Dialysis WGs is provided, but clearly GRADE-ed as such and must be carefully considered by the treating physician, and adapted to individual patient needs as appropriate.
KW - Child
KW - Chronic Kidney Disease-Mineral and Bone Disorder/drug therapy
KW - Humans
KW - Meta-Analysis as Topic
KW - Observational Studies as Topic
KW - Practice Guidelines as Topic/standards
KW - Prospective Studies
KW - Randomized Controlled Trials as Topic
KW - Renal Dialysis
KW - Renal Insufficiency, Chronic/drug therapy
KW - Vitamin D/therapeutic use
KW - Vitamin D Deficiency/complications
U2 - 10.1093/ndt/gfx065
DO - 10.1093/ndt/gfx065
M3 - Article
C2 - 28873969
SN - 0931-0509
VL - 32
SP - 1098
EP - 1113
JO - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
IS - 7
ER -