Difficulties in optimizing vitamin D levels in paediatric cystic fibrosis patients

The 2007 guideline on bone mineralisation in CF specified target levels of vitamin D should be 75-150nmol/l to maintain bone health. This is above the normal target for the non CF population . Therefore we retrospectively reviewed our paediatric CF cohort over 2011-2013, on their annual assessments.We obtained data in relation to age, sex, weight, pubertal status, pancreatic status and use of steroids. Furthermore, their vitamin D level, compared the preparations they took; whether standards were met and highlighted interventions we made through the years. Issues such as compliance, adherence to treatment and the disease severity which can influence vitamin d levels were also taken into consideration. Results: 2011-2013 results 2011 n=73 2012 n=80 2013 n=62 Vitamin D Prep apprioriate daily dose 55% ( 40/73) 57.5% (46/80) 84% (52/62) % Meeting Vitamin D level ( 75-150nmmol/l ) 17.7% 6.25% 11.6% Improvement from previous years 15% 67.7% The data shows that many of our patients were not receiving the appropriate preparations and therefore the correct daily dose of vitamin D for their age. Issues of compliance, taste of preparations and CF disease severity within that year were definite contributing factors. In 2012 many patients were changed to cholecalciferol showing improvements, and meeting of standards of vitamin D in the proceeding year. The study did not highlight which preparation was superior and despite suboptimal vitamin D levels nor the impact on bone mineralization.Conclusion:Achieving vitamin D levels is multi-factorial. Larger prospective studies are needed looking at individual preparations and relationship to vitamin d levels and bone health in CF patients to provide substantial information.