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Clinical practice recommendations for native vitamin D therapy in children with chronic kidney disease stages 2-5 and on dialysis

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Abstract
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 D-2) and cholecalciferol (vitamin D-3) 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.
Keywords
RANDOMIZED-CONTROLLED-TRIAL, SERUM 25-HYDROXYVITAMIN D, D-DEFICIENCY, RICKETS, BONE-MINERAL DENSITY, D SUPPLEMENTATION, NUTRITIONAL RICKETS, PARATHYROID-HORMONE, HEMODIALYSIS-PATIENTS, D INSUFFICIENCY, SECONDARY, HYPERPARATHYROIDISM, children, cholecalciferol, chronic kidney disease (CKD), dialysis, vitamin D

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Citation

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Chicago
Shroff, Rukshana, Mandy Wan, Evi Nagler, Sevcan Bakkaloğlu, Dagmar-C Fischer, Nicholas Bishop, Mario Cozzolino, et al. 2017. “Clinical Practice Recommendations for Native Vitamin D Therapy in Children with Chronic Kidney Disease Stages 2-5 and on Dialysis.” Nephrology Dialysis Transplantation 32 (7): 1098–1113.
APA
Shroff, R., Wan, M., Nagler, E., Bakkaloğlu, S., Fischer, D.-C., Bishop, N., Cozzolino, M., et al. (2017). Clinical practice recommendations for native vitamin D therapy in children with chronic kidney disease stages 2-5 and on dialysis. NEPHROLOGY DIALYSIS TRANSPLANTATION, 32(7), 1098–1113.
Vancouver
1.
Shroff R, Wan M, Nagler E, Bakkaloğlu S, Fischer D-C, Bishop N, et al. Clinical practice recommendations for native vitamin D therapy in children with chronic kidney disease stages 2-5 and on dialysis. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2017;32(7):1098–113.
MLA
Shroff, Rukshana, Mandy Wan, Evi Nagler, et al. “Clinical Practice Recommendations for Native Vitamin D Therapy in Children with Chronic Kidney Disease Stages 2-5 and on Dialysis.” NEPHROLOGY DIALYSIS TRANSPLANTATION 32.7 (2017): 1098–1113. Print.
@article{8529338,
  abstract     = {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 D-2) and cholecalciferol (vitamin D-3) 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.},
  author       = {Shroff, Rukshana and Wan, Mandy and Nagler, Evi and Bakkalo\u{g}lu, Sevcan and Fischer, Dagmar-C and Bishop, Nicholas and Cozzolino, Mario and Bacchetta, Justine and Edefonti, Alberto and Stefanidis, Constantinos J and Vande Walle, Johan and Haffner, Dieter and Klaus, G{\"u}nter and Schmitt, Claus Peter},
  issn         = {0931-0509},
  journal      = {NEPHROLOGY DIALYSIS TRANSPLANTATION},
  keyword      = {RANDOMIZED-CONTROLLED-TRIAL,SERUM 25-HYDROXYVITAMIN D,D-DEFICIENCY,RICKETS,BONE-MINERAL DENSITY,D SUPPLEMENTATION,NUTRITIONAL RICKETS,PARATHYROID-HORMONE,HEMODIALYSIS-PATIENTS,D INSUFFICIENCY,SECONDARY,HYPERPARATHYROIDISM,children,cholecalciferol,chronic kidney disease (CKD),dialysis,vitamin D},
  language     = {eng},
  number       = {7},
  pages        = {1098--1113},
  title        = {Clinical practice recommendations for native vitamin D therapy in children with chronic kidney disease stages 2-5 and on dialysis},
  url          = {http://dx.doi.org/10.1093/ndt/gfx065},
  volume       = {32},
  year         = {2017},
}

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