O-16 EVALUATION OF THE RESPONSE TO TREATMENT OF VITAMIN D DEFICIENCY IN PEDIATRIC PATIENTS WITH CHRONIC LIVER DISEASE

Background

Vitamin D deficiency prevalence is high in children with chronic liver disease and there is no consensus about its best treatment.

Objective

To evaluate the prevalence of vitamin D deficiency in children with chronic liver disease, to identify clinical and laboratorial features related to it and to evaluate the response of treatment with 6000IU per day of cholecalciferol for 60 days or more.

Methods

Historical cohort that included patients younger than 18 years old, followed in Pediatric Hepatology Unit of Hospital de Clínicas de Porto Alegre from January 2015 to November 2020, who had at least one dosage of 25(OH)D before liver transplantation. Laboratorial data were evaluated before and after treatment with cholecalciferol. Clinical and laboratorial features of the group that responded to treatment was compared with the group that did not respond. Data were collected from patient's electronic charts.

Results

Ninety-six patients were included in the study. The prevalence of vitamin D deficiency was 67.7%. Patients with vitamin D deficiency were younger than patients without deficiency (p<0.001), had higher PELD, MELD and Child-Pugh scores (p=0.002 e p<0.001 respectively), higher levels of total bilirubin (p<0.001), gamma glutamyl transferase (p<0.001) and alkaline phosphatase (p=0.002) and lowers levels of phosphorus (p=0.009). Thirty-one patients were treated with 6000IU of cholecalciferol per day for 60 days or more. Only 29% of them achieved normal levels of 25(OH)D. Patients that responded to treatment had lower Child-Pugh score (p=0.001), lower level of total bilirubin at the moment of the second 25(OH)D dosage (p=0.001) and higher level of phosphorus (p=0.003).

Conclusion

Vitamin D deficiency in children with chronic liver disease is related to the severity of the liver disease and cholestasis. The treatment response rate is low. Normalization of 25(OH)D levels is associated with cholestasis improvement.