Therapy strategies in vitamin D deficiency with or without rickets: efficiency of low-dose stoss therapy

Background: Vitamin D deficiency can be treated with daily vitamin D supplementation for several weeks or single-day high-dose vitamin D therapy (stoss therapy). However, there are few studies comparing efficiency and side effects of these two treatment models. Objectives: We aimed to compare the efficiency and side effects of low-dose stoss therapy and lower-dose daily vitamin D supplementation in children with vitamin D deficiency. Materials and methods: Our subjects were 42 patients with ages between 5 months and 3 years with diagnosed vitamin D deficiency. All children had 25-hydroxyvitamin D level lower than 20 ng/mL. Serum biochemical markers and spot urine calcium/creatinine (Ca/Cr) ratio were measured before and after the therapy. Twenty-one patients were treated with stoss therapy (150,000 U/single-dose oral vitamin D3), and 21 patients were treated with daily high-dose vitamin D3 therapy (2000 U/day vitamin D, 6 weeks). Renal ultrasound was performed for both groups of patients after 1 month. Results: Biochemical parameters and Ca/Cr ratio at the end of therapy did not differ in each groups. However, vitamin D levels at the end of stoss therapy were significantly increased compared with daily lower-dose vitamin D therapy group (p < 0.001). Nephrocalcinosis or renal stone was not detected by renal ultrasound. Conclusion: In both groups, hypocalcemia was not detected during the therapy. There was no evidence about the increasing risk of hypercalciuria in low-stoss therapy. Higher vitamin D levels were obtained in low-stoss therapy group.