Vitamin D insufficiency, hemoglobin, and anemia in children with chronic kidney disease.
Document Type
Article
Publication Date
11-2018
Identifier
DOI: 10.1007/s00467-018-4020-5; PMCID: PMC6528819
Abstract
BACKGROUND: 25-Hydroxyvitamin D (25OHD) deficiency is common in children with chronic kidney disease (CKD). It has been associated with an increased risk for anemia in both healthy US children and in adults with CKD. This association has not been explored in children with CKD.
METHODS: Children aged 1-16 enrolled in the Chronic Kidney Disease in Children (CKiD) study with mild to moderate kidney dysfunction, and with 25OHD measured at baseline (n = 580), were included in the analysis. The cross-sectional associations between 25OHD and hemoglobin (g/dL) and anemia were assessed. Anemia was defined as hemoglobin < 5th percentile for age and sex.
RESULTS: Overall 334 (57.59%) children were vitamin D insufficient/deficient and 137 (23.62%) were anemic. Of those who were vitamin D insufficient/deficient, 95 (28.44%) were anemic. In the overall cohort, the odds of being anemic was 1.9 times higher (95% CI, 1.22-3.04, p < 0.01) in vitamin D insufficient/deficient vs sufficient children, when adjusting for covariates (age, sex, race [black, white, or other], body mass index (BMI), iohexol GFR (iGFR), erythropoietin stimulation agent (ESA) use, iron supplementation use, and underlying cause of CKD). Stratified by race, the odds of being anemic was 2.39 times higher (95% CI, 1.41-4.05, p = 0.001) in vitamin D insufficient/deficient vs vitamin D sufficient white children. The association between vitamin D status and anemia was not significant in black children.
CONCLUSIONS: The data support our hypothesis that vitamin D insufficiency/deficiency increases the odds of anemia in children with CKD. The effect was strong and significant among white, but not black, children.
Journal Title
Pediatric nephrology (Berlin, Germany)
Volume
33
Issue
11
First Page
2131
Last Page
2136
MeSH Keywords
Adolescent; Anemia; Child; Cross-Sectional Studies; Female; Hemoglobins; Humans; Male; Nutrition Surveys; Prospective Studies; Renal Insufficiency, Chronic; Risk Factors; Vitamin D; Vitamin D Deficiency
Keywords
Anemia; Chronic kidney disease; Hemoglobin; Vitamin D
Recommended Citation
Altemose KE, Kumar J, Portale AA, et al. Vitamin D insufficiency, hemoglobin, and anemia in children with chronic kidney disease. Pediatr Nephrol. 2018;33(11):2131-2136. doi:10.1007/s00467-018-4020-5
COinS
Comments
Grant support