An update on the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis: evidence-based recommendations from the Cystic Fibrosis Foundation

J Clin Endocrinol Metab. 2012 Apr;97(4):1082-93. doi: 10.1210/jc.2011-3050. Epub 2012 Mar 7.

Abstract

Objective: The objective was to develop evidence-based clinical care guidelines for the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis (CF).

Participants: The guidelines committee was comprised of physicians, registered dietitians, a pharmacist, a nurse, a parent of an individual with CF, and a health scientist, all with experience in CF.

Process: Committee members developed questions specific to vitamin D health in individuals with CF. Systematic reviews were completed for each question. The committee reviewed and graded the available evidence and developed evidence-based recommendations and consensus recommendations when insufficient evidence was available. Each consensus recommendation was voted upon by an anonymous process.

Conclusions: Vitamin D deficiency is common in CF. Given the limited evidence specific to CF, the committee provided consensus recommendations for most of the recommendations. The committee recommends yearly screening for vitamin D status, preferably at the end of winter, using the serum 25-hydroxyvitamin D measurement, with a minimal 25-hydroxyvitamin D concentration of 30 ng/ml (75 nmol/liter) considered vitamin D sufficient in individuals with CF. Recommendations for age-specific vitamin D intake for all individuals with CF, form of vitamin D, and a stepwise approach to increase vitamin D intake when optimal vitamin D status is not achieved are delineated.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 25-Hydroxyvitamin D 2 / blood
  • Adolescent
  • Adult
  • Age Factors
  • Calcifediol / blood
  • Child
  • Cholecalciferol / administration & dosage
  • Cholecalciferol / therapeutic use
  • Cystic Fibrosis / physiopathology*
  • Dietary Supplements*
  • Ergocalciferols / administration & dosage
  • Ergocalciferols / therapeutic use
  • Evidence-Based Practice
  • Humans
  • Infant
  • Malabsorption Syndromes / etiology
  • Malabsorption Syndromes / physiopathology
  • Mass Screening / methods*
  • Seasons
  • Vitamin D / administration & dosage*
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / diagnosis*
  • Vitamin D Deficiency / diet therapy*
  • Vitamin D Deficiency / etiology

Substances

  • Ergocalciferols
  • Vitamin D
  • Cholecalciferol
  • 25-Hydroxyvitamin D 2
  • Calcifediol