AI Article Synopsis
- Derangement of calcium and vitamin D levels is common in patients with nephrotic syndrome (NS), linked to protein loss, but the status of free levels remains uncertain.
- A pilot study with NS patients showed they had low free and total serum calcium and low vitamin D levels, improving with disease remission.
- The findings imply that while calcium and vitamin D supplements may not be necessary at the onset of NS, they might be beneficial for those with prolonged cases of the disease.
Article Abstract
Introduction: Derangement in calcium homeostasis is common in nephrotic syndrome (NS). It is postulated that low serum total calcium and vitamin D levels are due to loss of protein-bound calcium and vitamin D. 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 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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214354 | PMC |
| http://dx.doi.org/10.15605/jafes.036.01.12 | DOI Listing |
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