Free 25-hydroxyvitamin-D concentrations are lower in children with renal transplant compared with chronic kidney disease.
Background: Total serum 25-hydroxyvitamin D [25(OH)D] is considered the best marker of vitamin D status and used routinely in clinical practice. However, 25(OH)D is predominantly bound to vitamin D-binding protein (VDBP), and it has been reported that the free-25(OH)D and 25(OH)D loosely bound to al...
| Publicado en: | Pediatric Nephrology Vol. 35; no. 6; pp. 1069 - 1080 |
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| Autores principales: | , , , , , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142908702&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142908702 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Jun2020 vid: 35 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 142908702 142908702 142908702 10.1007/s00467-020-04472-z 142908702 ppf: 1069 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Free 25-hydroxyvitamin-D concentrations are lower in children with renal transplant compared with chronic kidney disease. aug: au: Preka, Evgenia Wan, Mandy Price, Karen L Long, David A Aitkenhead, Helen Shroff, Rukshana affil: Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK sug: subj: Vitamin D Kidney Transplantation In Infancy and Childhood Kidney Failure, Chronic Carrier Proteins Vitamin D Deficiency Human Biological Markers Comparative Studies Albumins Minerals Metabolism Dialysis Patients Multiple Regression Descriptive Statistics Child Parathyroid Hormones Child: 6-12 years ab: Background: Total serum 25-hydroxyvitamin D [25(OH)D] is considered the best marker of vitamin D status and used routinely in clinical practice. However, 25(OH)D is predominantly bound to vitamin D-binding protein (VDBP), and it has been reported that the free-25(OH)D and 25(OH)D loosely bound to albumin fraction correlates better with clinical outcomes. Methods: We assessed total-25(OH)D, measured free-25(OH)D, and calculated free-25(OH)D and their relationship with VDBP and biomarkers of mineral metabolism in 61 children (22 CKD 2–3, 18 dialysis, and 21 post-transplant). Results: Total-25(OH)D concentrations were comparable across the three groups (p = 0.09), but free- and bioavailable-25(OH)D (free- and albumin-25(OH)D) were significantly lower in the transplant group (both: p = 0.01). Compared to CKD and dialysis patients, the transplant group had significantly higher VDBP concentrations (p = 0.03). In all three groups, total-25(OH)D concentrations were positively associated with measured free-, calculated free-, and bioavailable-25(OH)D. Multivariable regression analysis showed that total-25(OH)D was the only predictor of measured free-25(OH)D concentrations in the dialysis group (β = 0.9; R2 = 90%). In the transplant group, measured free-25(OH)D concentrations were predicted by both total-25(OH)D and VDBP concentrations (β = 0.6, − 0.6, respectively; R2 = 80%). Correlations between parathyroid hormone with total-25(OH)D and measured and calculated free-25(OH)D were only observed in the transplant group (all: p < 0.001). Conclusions: In transplanted patients, VDBP concentrations were significantly higher compared to CKD and dialysis patients, and consequently, free-25(OH)D concentrations were lower, despite a comparable total-25(OH)D concentration. We suggest that free-25(OH)D measures may be required in children with CKD, dialysis, and transplant, with further research required to understand its association with markers of mineral metabolism. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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