Chesney R W, Hamstra A J, Mazess R B, Rose P, DeLuca H F
Kidney Int. 1982 Jan;21(1):65-9. doi: 10.1038/ki.1982.9.
Vitamin D metabolites were measured in children, untreated with glucocorticoids, who had renal disease. Two groups were defined in relation to endogenous creatinine clearance values: those with impaired clearance , 0 to 48 ml/min per 1.73 m2; and those with unimpaired clearance, 75 to 150 ml/min per 1.73 m2. Serum 1.25(OH)2D was 16 +/- (SD) 12 pg/ml in impaired patients (N=24) and 48 +/- 16 pg/ml in unimpaired patients (N=18). The latter level is not different from healthy childhood controls (43 +/- 12 pg/ml; N=194). Serum samples of 25(OH)D2 and D3 were comparable in each group and not different from control values of 33.2 +/- 10.3 ng/ml. Serum 24,25(OH)2D was 0.6 +/- (SD) 0.14 ng/ml in patients with a clearance of less than 13 ml/min per 1.73 m2, 1.39 +/- 0.54 ng/ml in those with a clearance of 18 to 48 ml/min per 1.73 m2, and 152 +/- 0.91 ng/ml in patients without an impairment of clearance. Only patients with the lowest clearance had values different from control values of 1.70 +/- 0.57 ng/ml. In our study we suggest that a significant reduction in 24,25(OH)2D and 1,25(OH)2D are found at low clearance values in children with tubulointerstitial disease. Our study further suggests that a reduction in renal tubular mass is important in accounting for these changes in vitamin D metabolite values.
对未接受糖皮质激素治疗的肾病患儿的维生素D代谢产物进行了测定。根据内生肌酐清除率值定义了两组：清除率受损组，每1.73平方米0至48毫升/分钟；清除率未受损组，每1.73平方米75至150毫升/分钟。清除率受损患者（N = 24）的血清1,25(OH)₂D为16±（标准差）12皮克/毫升，清除率未受损患者（N = 18）为48±16皮克/毫升。后者水平与健康儿童对照组（43±12皮克/毫升；N = 194）无差异。每组中25(OH)D₂和D₃的血清样本具有可比性，且与33.2±10.3纳克/毫升的对照值无差异。每1.73平方米清除率低于13毫升/分钟的患者血清24,25(OH)₂D为0.6±（标准差）0.14纳克/毫升，每1.73平方米清除率为18至48毫升/分钟的患者为1.39±0.54纳克/毫升，清除率未受损的患者为1.52±0.91纳克/毫升。只有清除率最低的患者的值与1.70±0.57纳克/毫升的对照值不同。在我们的研究中，我们认为在患有肾小管间质疾病的儿童中，低清除率值时24,25(OH)₂D和1,25(OH)₂D会显著降低。我们的研究进一步表明，肾小管质量的减少对于解释这些维生素D代谢产物值的变化很重要。
