Vitamin D metabolites in childhood nephrotic syndrome

Grymonprez, A; Proesmans, Willem; Dyck, Maria Van; Jans, Ivo; Goos, G; Bouillon, Roger

doi:10.1007/bf02254183

Cited by 71 publications

(48 citation statements)

References 21 publications

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“…The data in the literature on changes in the DBP and total 1,25(OH) 2 D in nephrotic syndrome are equivocal. Some authors report lower concentrations of DBP (2,20,21), and in some studies a correlation between serum albumin and DBP levels was found (12,21). In contrast, other investigators report unchanged levels of DBP in patients with nephrotic syndrome (22).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between free and total 1,25-dihydroxyvitamin D in conditions of modified binding

Hoof¹,

Sévaux

Baelen

et al. 2001

European Journal of Endocrinology

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Objective: A novel assay was employed to study the free 1,25-dihydroxyvitamin D (1,25(OH) 2 D) concentrations in various populations with different levels of 1,25(OH) 2 D and vitamin D binding protein (DBP). Design: In 12 healthy women before and after 3 months of oral estrogen/progestagen treatment, 10 pregnant women, and 16 patients with a nephrotic syndrome and normal renal function, the concentrations of total and free 1,25(OH) 2 D, DBP and albumin were assessed. Methods: The total concentration of 1,25(OH) 2 D in serum was assessed using a radioreceptor assay. The free fraction of 1,25(OH) 2 D was measured using symmetric dialysis. DBP was assessed using single radial immunodiffusion. Serum albumin concentrations were measured on an automated analyzer. Results: In healthy women, the concentrations of total 1,25(OH) 2 D, free 1,25(OH) 2 D and DBP were 132^19 pmolalY 92^30 fmolal and 5X59^0X43 mmolalX After 3 months of estrogen/progestagen treatment, total 1,25(OH) 2 D and DBP levels rose significantly to 175^51 pmolal and 8X321 X59 mmolal P # 0X05 and P # 0X001; the free 1,25(OH) 2 D remained unchanged 1053 9 fmolal; not significant). Pregnant women had significantly higher levels of total 1,25(OH) 2 D and DBP 239^68 pmolal and 11X32^1X77 mmolal; both P # 0X001; the free 1,25(OH) 2 D level, however, was not different 104^27 fmolal; not significant). Unexpectedly, in patients with nephrotic syndrome, no lower DBP levels were found 5X36^0X84 mmolal relative to that in controls. Despite this, levels of both total 69^26 pmolalY P # 0X001 and free 1,25(OH) 2 D 532 8 fmolal; P # 0X001 were significantly lower than in controls. Albumin levels were lowered from 628^38 mmolal to 300^84 mmolal (P # 0.001). Conclusions: Higher estrogen levels result in higher DBP levels, with a parallel rise in total 1,25(OH) 2 D levels but without a change in the biologically active free fraction. The results in patients with nephrotic syndrome show that, with increasing glomerular protein leakage, the free 1,25(OH) 2 D concentration cannot be maintained.

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Section: Discussionmentioning

confidence: 99%

“…In contrast, other investigators report unchanged levels of DBP in patients with nephrotic syndrome (22). Likewise, total 1,25(OH) 2 D levels have been found to have decreased (12,21,23,24) or to have been unchanged (22,25) in patients with nephrotic syndrome.…”

Section: Discussionmentioning

confidence: 99%

Relationship between free and total 1,25-dihydroxyvitamin D in conditions of modified binding

Hoof¹,

Sévaux

Baelen

et al. 2001

European Journal of Endocrinology

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“…This could represent chronic inflammation, an aspect of many comorbid illnesses, which may also associated with decreased UV exposure; however, further adjustment for several documented comorbidities (coronary artery disease, hypertension, chronic obstructive pulmonary disease, cancer, peripheral vascular disease, stroke, congestive heart failure, and liver disease), white blood count, and ferritin did not materially alter the relationship of albumin with vitamin D deficiency. Another such mechanism might be nephrotic syndrome, which is associated with urinary losses of albumin and may also contribute to loss of vitamin D binding protein, the major carrier protein for vitamin D (35,36).…”

Section: Discussionmentioning

confidence: 99%

Clinical Measures Identify Vitamin D Deficiency in Dialysis

Bhan¹,

Burnett-Bowie

Ye³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: Vitamin D deficiency (defined by serum levels of 25-hydroxyvitamin D) is common in patients with ESRD on hemodialysis, but risk factors are unknown. This study was conducted to determine whether routinely measured clinical and demographic parameters could identify dialysis patients who are vitamin D deficient.Design, setting, participants, & measurements: Nine-hundred eight patients with 25-hydroxyvitamin D levels were identified from the Accelerated Mortality on Renal Replacement (ArMORR) cohort of incident U.S. dialysis patients and were divided into training (60%) and validation (40%) sets. Predictive models were generated from routinely assessed clinical and demographic data in the training set using logistic regression modeling, neural networks, and decision trees with vitamin D deficiency as the dependent variable. Models underwent progressive variable reduction to identify the simplest model that remained predictive.Results: Seventy-nine percent of the population was vitamin D deficient (25-hydroxyvitamin D <30 ng/ml). Black race, female sex, winter season, and hypoalbuminemia (serum albumin <3.1 g/dl) were the strongest predictors of vitamin D deficiency. In the validation set, the presence of hypoalbuminemia and winter season increased the likelihood of vitamin D deficiency in black women (from 90% to 100%), black men (from 85% to 100%), white women (from 82% to 94%), and white men (from 66% to 92%).Conclusions: Deficiency of 25-hydroxyvitamin D is nearly universal among patients with hypoalbuminemia initiating chronic hemodialysis in winter.

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“…All patients aged more than 18 years, who presented with nephrotic syndrome, were included in the study. Nephrotic syndrome was defined as 24-h urinary protein excretion >3.5 g/1.73m 2 or spot urinary protein creatinine ratio >2.0. Patients with acute sickness, pregnancy, lactation, diabetes mellitus and previously diagnosed patients with hypothyroidism were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 Urinary loss of thyroid binding globulin is accompanied with loss of thyroxine (T4) and triiodothyronine (T3). [3][4][5][6] This leads to decrease in serum total thyroxine (TT4) and serum total triiodothyronine (TT4) concentrations and increases the demand on thyroid gland to produce more T4.…”

Section: Introductionmentioning

confidence: 99%