Vitamin D supplementation in theory and daily practice – implementation of new updated Polish recommendations on the example of one pediatric centre

Introduction
According to updated evidence-based national recommendations which have been published recently vitamin D deficiency remains still highly prevalent in Poland and requires supplementation.

Aim of the study
was to evaluate the effectiveness of implementation of the new national recommendations into daily practice.

Material and methods
An analysis of medical records of 100 children aged from 6 months to 14 years admitted to the Department of Pediatrics, Hospital in Brzesko, Lesser Poland, from 1st July 2018 to 31st August 2018.

Results
41% patients declared vitamin D supplementation. Among patients under 1 year of age 3 (60%) received recommended supplementation of 400-600 IU daily, in the group of 1-11 years old 15 (19.5%) used a 600-1000 IU dose daily, 13 (17%) < 600 IU/daily, and 2 (2.5%) > 1000 IU daily, 1 patient did not remember the dose. In the group >11 years of age 6 (37.5%) supplemented 800-2000 IU/day, 1 (6.3%) less than 800 IU, no one overdosed supplementation. In the group without supplementation, there were 3 patients with a de-creased 25(OH)D blood serum level (< 20 ng/ml). Mean 25(OH)D serum level was significantly higher in the group with vitamin D supplementation (42 vs. 33.9 ng/ml; p = 0.0006). There was no significant difference between mean 25(OH)D level in patients receiving adequate (40.5 ng/ml), to low (43 ng/ml), or to high vitamin D doses (49 ng/ml). There was no significant correlation between vitamin D dose and the 25(OH)D serum level [R = (–) 0.24, p > 0.05)].

Conclusions
There is an urgent need for physicians to provide an education concerning general rules of vitamin D supplementation, because the pre-sent guidelines of the vitamin D supplementation are not implemented well enough.