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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2013.201aasm-2-201aCommentsClinicians should be more prone to examine children with chronic kidney disease in terms of vitamin D deficiency Balta Sevket aCakar Mustafa bDemirbas Seref bDemirkol Sait a
a Cardilology, Gulhane Medical Faculty, Ankara, Turkey
b Internal Medicine, Gulhane Medical Faculty, Ankara, TurkeyCorrespondence: Dr. Mustafa Cakar, Internal Medicine, Gulhane Medical Faculty, Etlik, Ankara 06100 Turkey, drmustafacakar@gmail.comMar-Apr 2013 33 2 201 201 Copyright © 2013, Annals of Saudi Medicine2013This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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To the Editor: We read the article “Vitamin D insufficiency and deficiency in children with chronic kidney disease” written by Kari et al with interest.1 The authors concluded that vitamin D insufficiency/deficiency was more frequent in children with chronic kidney disease (CKD) than in those with normal kidney function. Thank to the authors for their contribution of a study successfully designed. We believe that these findings will guide further studies about vitamin D levels and chronic renal failure.

A previous study including 400 adult healthy subjects in Saudi Arabia reported that 98 subjects (24.5%) had insufficiency (21–29 pg/mL) and 52 subjects (13%) had deficiency (<20 pg/mL) of 25OHD levels.2 Certainly the results in adult patients may not reflect the specifications of children, but some extrapolation of data can be made. The control group of the present study had similar results. In addition to the baseline levels in a healthy population, patients with CKD are expected to have lower levels of vitamin D due to the defective enzymatic transformation.3 Thus, the results of the study are expected. As in adults, CKD is a difficult challenge in terms of follow up, treatment and complications. This study deserves emphasis in terms of underlining the condition of vitamin D deficiency particularly in children with CKD. We think that treatment of calcium, phosphorus, parathyroid hormone and vitamin D levels are only part of the whole condition and clinicians should be more prone to examine patients in detail in terms of physical and laboratory findings in the follow up of CKD patients.
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REFERENCES
1 Kari JA  El Desoky SM  El-Morshedy SM  Habib HS   Vitamin D insufficiency and deficiency in children with chronic kidney disease Annals of Saudi Medicine 2012 32 5 473 8 22871615 
2 Sadat-Ali M  Al Elq AH  Al-Turki HA  Al-Mulhim FA  Al-Ali AK   Influence of vitamin D levels on bone mineral density and osteoporosis Annals of Saudi Medicine 2011 31 6 602 8 22048506 
3 Belostotsky V  Mughal MZ  Berry JL  Webb NJA   Vitamin D deficiency in children with renal disease Archives of Disease in Childhood 2008 11 93 11 959 62 18463127