What Is the First-Line Treatment of Rickets?
Rickets arises when the growing skeleton fails to mineralise adequately. The first-line protocol targets the underlying nutritional deficits and monitors resolution through specific biochemical markers.
Treatment Approach
The first-line approach centres on correcting calcium intake appropriate to the child's age and ensuring adequate vitamin D status — the two essential substrates for physiological skeletal mineralisation. The full structured regimen, including age-specific targets and monitoring intervals, is available via the protocol.
Treatment Goals
- Serum 25(OH)D level greater than 50 nmol/L
- Normalisation of serum calcium and phosphate
- Normalisation of alkaline phosphatase (ALP)
- Normalisation of parathyroid hormone (PTH)
References
DOI: 10.1007/s00467-022-05505-5
- For physiological skeletal mineralization, infants aged 0–6 months (6–12 months) require a calcium intake of 200 mg/day (260 mg/day), and children and adolescents require 500 mg/day, respectively, and a 25(OH)D level greater than 50 nmol/L (20 ng/L).
- This must be assured in any child presenting with rickets.
- Normalization of serum ALP, calcium, phosphate, and PTH levels indicates healing of rickets.
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