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Poster: Adherence and Transition

P.242 CALCIDIOL INSUFFICIENCY IN KIDNEY TRANSPLANTED CHILDREN IMPROVE MORE WITH SPORT PRACTICE THAN ISOLATED ORALLY CHOLECALCIFEROL. A. Alonso, S. Rodriguez, L. Espinosa, C. Garc ıa, M. Melgosa, A. Camarena, C. Fern andez. Paediatric Nephrology, Hospital La Paz, Madrid, Spain. OBJECTIVES: To know the factors influencing plasma calcidiol levels in kidney transplanted children. MATERIAL AND METHODS: We analyzed 421 plasma calcidiol determinations from 111 kidney transplanted children of 9.4 years (71% male) and 3 years of evolution. According to a physical activity survey, they were classified into 4 groups: none, exclusively at school, scheduled activity in a gym or a swimming pool and open-air sport. The relationship between plasma calcidiol levels and the amount and type of oral intake of vitamin D, kidney function, immunosuppression type, residential area and physical activity was analyzed. RESULTS: Plasma calcidiol was deficient (<15 ng/ml) in 2.5% of the determinations; insufficient (15–30 ng/ml) in 67% and sufficient (30–100 ng/ml) in only 30%. There was seasonal variability with a slight increase in summer and autumn in contrast to winter and spring. The children living in the Iberian Peninsula had lower levels than those living in the Canary Islands: 26 8 in contrast to 32 10 ng/ml. Those patients with insufficient or deficient plasma calcidiol levels presented the same glomerular filtration rate as those with sufficient levels, both if it was estimated by creatinine (97 vs.102 ml/min/ 1.73 m) or by cystatin C: (75 vs.76 ml/min/1.73 m). The oral Cholecalciferol did not significantly improve plasma calcidiol levels: 26 10 ng/ml vs. 29 15 ng/ ml.; nonetheless, the patients with a scheduled physical activity, both indoors and outdoors, presented sufficient plasma calcidiol levels in a higher percentage than those who were sedentary: 67 vs. 36%. DISCUSSION: Children who have undergone a kidney transplant often present calcidiol insufficiency, even with normal glomerular filtration rate. The treatment with oral Cholecalciferol does not always amend the alteration, while its use combined with the practice of any sport, significantly improves the plasma levels.