Pediatria pre prax 6/2020

Vitamin D – Do we administer it correctly?

In the past, the occurrence of rickets was relatively frequent, however, in recent years. Thanks to decades of nationwide supplementation, rickets occurs only sporadically in our country. From a global point of view, vitamin D deficiency and rickets still represent a serious medical issue. Over the last decade, the view of the role of vitamin D has significantly changed. Due to this, the concentration of vitamin D in the population was largely investigated. The reference range for calcidiol was modified (norm above 30 ng/ml, insufficiency 20–30 ng/ml and deficiency below 20 ng/ml). In the pediatric population, groups of children at risk of possible vitamin D deficiency who need substitution according to calcidemia, have been profiled. The most endangered group are considered to be children with malabsorption syndrome or children treated with glucocorticoids for a long time. The latest recommendation for the prevention and treatment of vitamin D deficiency rickets (Global Consensus Recommendation on Prevention and Management of Nutritional Rickets) were published in 2016. After 3 months of treatments in age-dependent dose, preventive administration is continued as well as adequate calcium intake is maintained. This consensus mentioned above has proposed solutions to improve the worldwide vitamin D deficiency. One of the options might be to fortification of food.

Keywords: vitamin D, hypovitaminosis D, calcidiol, daily dose of cholecalciferol