Effects of 25-OHD3 on renal function in pediatric patients with chronic renal failure.

19 nondialyzed pediatric patients with chronic renal failure and renal osteodystrophy participated in a 4- year prospective trial of the effects of 25-hydroxycholecalciferol (25-OHD3) in the treatment and prevention of clinical symptoms of renal osteodystrophy. Controversy over the possible deleterious effects of other vitamin D metabolites, namely 1,25-dihydroxycholecalciferol and 1, alpha-hydroxyvitamin D3, led to an examination of the rate of decline in renal function both before and during treatment with 25-OHD3. Serum creatinine and glomerular filtration rates were stable in the patients who completed 2, 3, and 4 years of treatment with 25-OHD3. There was no acceleration in the deterioration of renal function during treatment with 25-OHD3 beyond that which would be expected without vitamin D therapy of any kind. There was an increase in mean serum creatinine after 1 year of treatment because 5 children who entered the study were already in the terminal (accelerated) phase of renal function deterioration. These children completed 1 year of therapy with 25-OHD3.