Vitamin D and calcium metabolism in children with nephrotic syndrome of normal renal function.

This study demonstrates that there are distinct abnormalities of vitamin D and calcium metabolism in children with nephrotic syndrome (NS) and normal renal function. In patients with active NS, serum calcium, ionized calcium, 25-OHD3 and CT were decreased, plasma PTH level was increased and serum ALP was elevated. These abnormalities returned to normal in remission. Serum 1,25-(OH)2D3, although normal in absolute value during both active and remission stage, may be inappropriately low for the hypocalcemia and hyperparathyroidism during the active stage. Therefore, children with active NS are at the risk of developing metabolic bone disease. The treatment with a high dose of vitamin D3 may correct the abnormalities, which suggests vitamin D3 should be used in children with protracted active NS.