Effects of Supplementary Vitamin D on Vitamin D3 Serum Level in Nephrotic Syndrome Patients Receiving Steroid Therapy

Abstract

Introduction: Nephrotic syndrome is one of the most common glomerular diseases in children who are also at risk of metabolic bone diseases. In this study the effect of supplementary use of vitamin D3 was assessed on serum levels of vitamin D3 in patients with nephrotic syndrome receiving steroid therapy. Methods: Thirty children with nephrotic syndrome were included in this study. After obtaining blood samples to measure 25(OH) D levels, all patients were supplemented with daily doses of Vitamin D for one month. Serum 25(OH) D level was checked again, and these patients were supplemented for another month if they had been recognized with deficiency at the last check. Results: Out of 30 children, 60% were male and 40% were female with a mean age of 6.91 ± 3.34 years. Before intervention, 70% of patients had severe vitamin D deficiency, and 26.7% had mild to moderate deficiency, and none of the patients had normal serum levels of 25-(OH)-D. After one month, only one patient gained normal levels which was not statistically significant (P=0.500). After two months of intervention, 12 patients escaped deficiency but still exhibited insufficient levels followed by 8 people with deficiency, and 10 patients reached normal values which was statistically significant (P=0.002). The mean level of 25(OH) D was 8.277±0.84 ng/ mL rising to 14.364±1.14 ng/mL after two months (P=0.001). Conclusion: This study showed a high incidence of vitamin D deficiency in the children with nephrotic syndrome warranting routine surveillance of vitamin D serum levels in these patients. Daily doses of vitamin D in the first month of onset of the disease was insufficient. We suggest that children may benefit from routine measurement of their serum vitamin D from diagnosis and later in follow-up visits so an individual strategy for vitamin D supplementation could be given.

Keywords

• nephrotic syndrome
• serum vitamin d3 level
• glucocorticoids
• vitamin d supplementation