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The extent to which calcium\u2010deficiency rickets is the dominant form across sub\u2010Saharan Africa and in other low\u2010latitude areas is unknown. We aimed to characterise the clinical and biochemical features of young children with rickets in a densely populated urban informal settlement in Kenya. Because malnutrition may mask the clinical features of rickets, we also looked for biochemical indices of risk in children with varying degrees of acute malnutrition. Twenty one children with rickets, aged 3 to 24\u00a0months, were identified on the basis of clinical and radiologic features, along with 22 community controls, and 41 children with either severe or moderate acute malnutrition. Most children with rickets had wrist widening (100%) and rachitic rosary (90%), as opposed to lower limb features (19%). Developmental delay (52%), acute malnutrition (71%), and stunting (62%) were common. Compared to controls, there were no differences in calcium intake, but most (71%) had serum 25\u2010hydroxyvitamin D levels below 30\u00a0nmol\/L. These results suggest that rickets in young children in urban Kenya is usually driven by vitamin D deficiency, and vitamin D supplementation is likely to be required for full recovery. Wasting was associated with lower calcium (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.001), phosphate (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), 25\u2010hydroxyvitamin D (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.049), and 1,25\u2010dihydroxyvitamin D (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.022) levels, the clinical significance of which remain unclear.<\/jats:p>","DOI":"10.1111\/mcn.12452","type":"journal-article","created":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T03:52:39Z","timestamp":1493869959000},"source":"Crossref","is-referenced-by-count":27,"title":["Vitamin D deficiency causes rickets in an urban informal settlement in Kenya and is associated with malnutrition"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1237-0127","authenticated-orcid":false,"given":"Kelsey D. 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Samira","family":"Nassir","sequence":"additional","affiliation":[{"name":"Baraka Health Centre German Doctors Nairobi  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"H\u00fcnten\u2010Kirsch","sequence":"additional","affiliation":[{"name":"Baraka Health Centre German Doctors Nairobi  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Prentice","sequence":"additional","affiliation":[{"name":"MRC Human Nutrition Research Elsie Widdowson Laboratory  Cambridge UK"},{"name":"MRC Keneba  The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Berkley","sequence":"additional","affiliation":[{"name":"KEMRI\u2010Wellcome Trust Research Programme  Kenya"},{"name":"Nuffield Department of Clinical Medicine University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,3]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Association for Clinical Biochemistry and Laboratory Medicine. 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