Hypervitaminosis A is prevalent in children with CKD and contributes to hypercalcemia

Background Vitamin A accumulates in renal failure, but the prevalence of hypervitaminosis A in children with predialysis chronic kidney disease (CKD) is not known. Hypervitaminosis A has been associated with hypercalcemia. In this study we compared dietary vitamin A intake with serum retinoid levels...

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Published in:Pediatric nephrology (Berlin, West) West), 2015-02, Vol.30 (2), p.317-325
Main Authors: Manickavasagar, Baheerathi, McArdle, Andrew J., Yadav, Pallavi, Shaw, Vanessa, Dixon, Marjorie, Blomhoff, Rune, Connor, Graeme O’, Rees, Lesley, Ledermann, Sarah, van’t Hoff, William, Shroff, Rukshana
Format: Article
Language:English
Subjects:
Adolescent
Care and treatment
Child
Child, Preschool
Chromatography, High Pressure Liquid
Diagnosis
Diet
Dietary supplements
Female
Hemodialysis
Humans
Hypercalcemia
Hypercalcemia - etiology
Hypervitaminosis A - complications
Infant
Kidney diseases
Male
Medicine
Medicine & Public Health
Metabolites
Nephrology
Nutrition research
Original
Original Article
Pediatrics
Proteins
Renal Insufficiency, Chronic - blood
Renal Insufficiency, Chronic - complications
Risk factors
Urology
Vitamin A
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Summary:Background Vitamin A accumulates in renal failure, but the prevalence of hypervitaminosis A in children with predialysis chronic kidney disease (CKD) is not known. Hypervitaminosis A has been associated with hypercalcemia. In this study we compared dietary vitamin A intake with serum retinoid levels and their associations with hypercalcemia. Methods We studied the relationship between vitamin A intake, serum retinoid levels, and serum calcium in 105 children with CKD stages 2–5 on dialysis and posttransplant. Serum retinoid measures included retinol (ROH), its active retinoic acid (RA) metabolites [all-trans RA (at-RA) and 13-cis RA] and carrier proteins [retinol-binding protein-4 (RBP4) and transthyretin (TTR)]. Dietary vitamin A intake was assessed using a food diary. Results Twenty-five children were in CKD 2–3, 35 in CKD 4–5, 23 on dialysis and 22 posttransplant; 53 % had vitamin A intake above the Reference Nutrient Intake (RNI) value. Children receiving supplemental feeds compared with diet alone had higher vitamin A intake ( p  = 0.02) and higher serum ROH ( p  
ISSN:0931-041X
1432-198X
1432-198X
DOI:10.1007/s00467-014-2916-2