Abstract
ABSTRACTPurpose:Hypercalciuria is one of the risk factors for calcium kidney stone formation (the most common type of urinary stones). Although vitamin D deficiency is prevalent among urolithiasis patients, the effect of vitamin D supplementation on urine calcium in these patients is still unclear.Materials and Methods:In this retrospective study, medical and laboratory tests records of 26 patients with recurrent calcium kidney stones and vitamin D deficiency treated with 50000IU vitamin D per week for 8-12 weeks were analyzed. The changes in 24-hour urine calcium (24-h Ca), serum 25-hydroxyvitamin D (25 (OH) D), serum parathormone (PTH), other 24-hour urine metabolites and calculated relative supersaturations of calcium oxalate (CaOxSS), calcium phosphate (CaPSS) and uric acid (UASS) were assessed. Moreover, correlations between changes in 24-h Ca and other aforementioned variables were assessed.Results:Serum 25 (OH) D and 24-h Ca increased after vitamin D supplementation, while serum PTH decreased (p < 0.001, for all analyses). The levels of 24-hour urine sodium and urea increased significantly (p = 0.005 and p = 0.031, respectively). The levels of CaOxSS and CaPSS increased, but the changes were not significant (p = 0.177, and p = 0.218, respectively). There were no correlations between the changes in 24-h Ca and serum 25 (OH) D or PTH.Conclusions:The result of current study suggests that although urine Ca increased in vitamin D supplemented patients, this increase was not associated with the increase in serum vitamin D and may be due to other factors such as dietary factors. Further randomized clinical trials considering other factors associated with urine Ca are warranted.
Highlights
The urinary stone disease is a common disease with a high risk of recurrence and increasing prevalence around the World [1]
The current study aims to evaluate the effect of vitamin D supplementation on 24-hour urine Ca in a group of patients with recurrent Ca kidney stones and vitamin D deficiency
Patients with history of recurrent kidney stones [15] and vitamin D deficiency [serum 25 hydroxyvitamin D (25 (OH) D) below 30ng / mL] who were treated with 50000IU vitamin D per week for 8-12 weeks, according to patient’s demographic and anthropometric data [8], were enrolled
Summary
The urinary stone disease is a common disease with a high risk of recurrence and increasing prevalence around the World [1]. Calcium (Ca) stones are the most common type of urinary stones in many countries, including Iran [2]. Hypercalciuria is the most common risk factor for Ca kidney stone in many countries [3]. Many factors including non-dietary and dietary factors are shown to cause hypercalciuria; the exact impact of some of these factors on urinary Ca excretion is still unclear [4]. Vitamin D deficiency is one of the most common health problems all over the World. Studies have shown a high prevalence of moderate to severe vitamin D deficiency in various cities of Iran [5]. Because of the essential role of vitamin D in Ca homeostasis and bone health, as well as its role in different chronic diseases [6, 7], many guidelines emphasize the importance of treating vitamin D deficiency [8, 9]
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