Management of nutritional rickets in Indian children: a randomized controlled trial

Aggarwal V, Seth A, Marwaha RK, Sharma B, Sonkar P, Singh S, et al.

Published in J Trop Pediatr, Vol. 59 (2), pp. 127-33

Methodology

Randomised trial in 67 Indian children aged 6 months to 5 years with nutritional rickets, given vitamin D (600,000 IU intramuscular, once), calcium (75 mg/kg/day) or both for 12 weeks. Healing judged by X-rays and blood chemistry.

Key Findings

Dietary calcium intake was low (about 204 mg/day) and 82% had 25(OH)D below 20 ng/mL. The combined end point (normal alkaline phosphatase plus complete healing on X-ray) at 12 weeks was reached by 50% on combination therapy, 15.7% on vitamin D alone and 11.7% on calcium alone.

Conclusions

The best response was seen with vitamin D and calcium together rather than either alone.

Limitations

Small trial; the abstract does not describe blinding; short follow-up of 12 weeks; children with both low vitamin D and low calcium intake, so it cannot separate the two causes.