Nephrocalcinosis in Children Who Received High-dose Vitamin D

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2022 Mar 30

PMID 35352189

Authors

Tzu-Hua Lin

Hsiang-Ju Lu

Chao-Hsu Lin

Ming-Dar Lee

Brian Pin-Hsuan Chang

Chun-Chen Lin

Jeng-Daw Tsai

Affiliations

Soon will be listed here.

Abstract

Background: Vitamin D supplements are readily available as over-the-counter preparations. However, although rare, cases of vitamin D overdose still occur and are associated with nephrocalcinosis and life-threatening hypercalcemia. Errors in manufacturing of nutritional supplements may be a cause of vitamin D intoxication in children. This study aimed to identify factors associated with vitamin D overdose-related nephrocalcinosis in children due to manufacturing errors in supplements.

Methods: This retrospective study reviewed medical charts of pediatric patients with non-registered supplement-related vitamin D overdose at a tertiary referral hospital between 2006 and 2011. Clinical and laboratory characteristics of patients with or without nephrocalcinosis were evaluated. Receiver operating characteristics curve and area under the receiver operating characteristics curve were used to determine the most predictive value of each characteristic.

Results: A total of 44 patients (males: 29; age: 7-62 months) were included. Age ≤ 16.5 months, body weight ≤ 10.25 kg, body height ≤ 78.5 cm, body surface area (BSA) ≤ 0.475 m, 25-hydroxyvitamin D ≥ 143 ng/mL, and calcium ≥ 10.65 mg/dL were predictive of developing nephrocalcinosis with a sensitivity and specificity of > 60%. Univariant analysis revealed that BSA was the most significant anthropometric prognostic factor (odds ratio: 12.09; 95% confidence interval: 2.61-55.72; P = 0.001).

Conclusions: Children with smaller BSAs were more vulnerable to high-dose vitamin D-related nephrocalcinosis. Physicians and parents should be aware of the potential adverse effects of vitamin D overdose in children. A higher resolution version of the Graphical abstract is available as Supplementary information.

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