Indian Academy of Pediatrics Revised (2021) Guidelines on Prevention and Treatment of Vitamin D Deficiency and Rickets

Autor: Piyush Gupta, Aashima Dabas, Anju Seth, Vijay Lakshmi Bhatia, Rajesh Khadgawat, Praveen Kumar, S. Balasubramanian, Vaman Khadilkar, H. B. Mallikarjuna, Tushar Godbole, Sriram Krishnamurthy, Jagdish Prasad Goyal, Bhanu Kiran Bhakhri, Ayesha Ahmad, Kumar Angadi, G. V. Basavaraja, Bakul J. Parekh, Anura Kurpad, R. K. Marwaha, Dheeraj Shah, Craig Munns, H. P. S. Sachdev
Rok vydání: 2021
Předmět:
Zdroj: Indian Pediatrics. 59:142-158
ISSN: 0974-7559
0019-6061
Popis: The emerging literature on prevalence of vitamin D deficiency in India, prevention and treatment strategies of rickets, and extra-skeletal benefits of vitamin D suggest the need for revising the existing guidelines for prevention and treatment of vitamin D deficiency in India.To review the emerging literature on vitamin D prevalence and need for universal vitamin D supplementation. To suggest optimum vitamin D therapy for treatment of asymptomatic and symptomatic vitamin D deficiency, and rickets. To evaluate the extra-skeletal health benefits of vitamin D in children.A National consultative committee was formed that comprised of clinicians, epidemiologists, endocrinologists, and nutritionists. The Committee conducted deliberations on different aspects of vitamin D deficiency and rickets through ten online meetings between March and September, 2021. A draft guideline was formulated, which was reviewed and approved by all Committee members.The group reiterates the serum 25-hydroxy vitamin D cutoffs proposed for vitamin D deficiency, insufficiency, and sufficiency as12 ng/mL, 12-20 ng/mL and20 ng/mL, respectively. Vitamin D toxicity is defined as serum 25OHD100 ng/mL with hypercalcemia and/or hypercalciuria. Vitamin D supplementation in doses of 400 IU/day is recommended during infancy; however, the estimated average requirement in older children and adolescents (400-600 IU/day, respectively) should be met from diet and natural sources like sunlight. Rickets and vitamin D deficiency should be treated with oral cholecalciferol, preferably in a daily dosing schedule (2000 IU below 1 year of age and 3000 IU in older children) for 12 weeks. If compliance to daily dosing cannot be ensured, intermittent regimens may be prescribed for children above 6 months of age. Universal vitamin D supplementation is not recommended in childhood pneumonia, diarrhea, tuberculosis, HIV and non-infectious conditions like asthma, atopic dermatitis, and developmental disorders. Serum 25-hydroxy vitamin D level of20 ng/mL should be maintained in children with conditions at high-risk for vitamin deficiency, like nephrotic syndrome, chronic liver disease, chronic renal failure, and intake of anticonvulsants or glucocorticoids.
Databáze: OpenAIRE
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