Calcium, Vitamin D, and Bone Derangement in Nephrotic Syndrome

Take Home Messages:

Derangement in calcium homeostasis is common in nephrotic syndrome (NS). It is asuumed that low serum total calcium and vitamin D levels are due to loss of protein-bound calcium and vitamin D. But it is unclear if free calcium and free vitamin D levels are truly low.

The guideline is lacking with regards to calcium and vitamin D supplementation in NS.

This study aims to examine the calcium and vitamin D homeostasis and the impact on bone turnover in patients with nephrotic syndrome during treatment and remission.

This study suggested calcium and vitamin D replacement may not be indicated in early-phase nephrotic syndrome but may be considered in prolonged nephrotic syndrome.

Available Brand

Doctors Liked to Read More

Abstract

Aim

Aim of this study is to examine calcium and vitamin D homeostasis and bone turnover in NS to guide practice in calcium and vitamin D levels supplementation.

Methodology

This is a prospective pilot study of ten patients diagnosed with NS, and eight healthy controls. Calcium, vitamin D, and bone turnover-related analytes were assessed at baseline, partial and complete remission in NS patients and in healthy controls.

Results

NS patients had low free and total serum calcium, low total 25(OH)D, normal total 1,25(OH)D levels and lack of parathyroid hormone response. With remission of disease, serum calcium and vitamin D metabolites improved. However, nephrotic patients who do not attain complete disease remission continue to have low 25(OH)D level.

Conclusion

In this study, the vitamin D and calcium derangement observed at nephrotic syndrome presentation trended towards normalisation in remission. This suggested calcium and vitamin D replacement may not be indicated in early-phase nephrotic syndrome but may be considered in prolonged nephrotic syndrome.

Rate This Article