Search results
This guideline provides recommendations on the treatment of established vitamin D deficiency in adults with eGFR >30 and low or normal serum calcium. This guideline is not for the general public with regards to maintaining good bone health and does not address the management of Vitamin D deficiency in childhood or adolescents or in pregnancy.
NHS England guidance advises that vitamin D may be prescribed for people with osteoporosis (often with calcium) or a chronic condition or surgery that results in deficiency or malabsorption.
Check biochemical profile (BCP), U+E, LFT and calcium before replacement. For high-risk patients (please see table below), BCP should be checked at weeks 1, 4, 8 and 12. The purpose is to avoid hypercalcaemia and acute kidney injury that occur (rarely) in association with vitamin D correction.
Specialist advice should be sought for the management of vitamin D deficiency in patients with severe or end-stage chronic kidney disease (CKD 4-5), severe liver disease, malabsorption syndromes, unexplained bone pain, unusual fractures, and other evidence of metabolic bone disorders.
This guideline covers the assessment and treatment of adults with vitamin D deficiency. It does not include pregnant women, children or patients with renal failure (<30ml eGFR. Seek specialist advice where appropriate). Vitamin D testing indicated Vitamin D testing not necessary with bone disease regardless of symptoms and risk factors
Routine vitamin D testing may be unnecessary in patients with osteoporosis or fragility fracture, who may be co-prescribed vitamin D supplementation with an oral antiresorptive treatment. Although vitamin D deficiency is highly prevalent, universal screening of asymptomatic populations is not recommended.
Routine monitoring of serum 25OHD is generally unnecessary but may be appropriate in patients with symptomatic vitamin D deficiency or malabsorption and where poor compliance with medication is suspected. Recheck after 1 year if needed.
