Abstract
Vitamin D supplementation in patients with urolithiasis and hypercalciuria is considered to be unsafe. We analyzed the impact of vitamin D supplementation on selected health status parameters in children with idiopathic hypercalciuria. The study included 36 children with urolithiasis resulting from excessive calcium excretion. The level of calcium and 25(OH)D (hydroxylated vitamin D - calcidiol) in serum, urinary calcium excretion and the presence of stones in urinary tract were assessed prospectively. Blood and urine samples were collected at the time when the patient was qualified for the study and every three months up to 24 month of vitamin D intake at a dose of 400 or 800 IU/day. At time zero and at 12, and 24 months of vitamin D supplementation, densitometry was performed. Supplementation with vitamin D caused a statistically significant increase in the concentration of 25(OH)D in serum. There were no significant changes in calcium concentration in serum, excretion of calcium in urine but also in bone density. There was no significant increase in the risk of formation or development of stones in the urinary tract. Supplementation with vitamin D (400–800 IU/day) in children with idiopathic hypercalciuria significantly increases 25(OH)D concentration, does not affect calciuria, but also does not improve bone density.
Highlights
Vitamin D is a fat-soluble steroid hormone, which regulates calcium and phosphate metabolism.The skin exposed to UVB radiation produces pre-vitamin D, which binds to the DBP protein, and is transported to the liver cells, where is hydroxylated to 25(OH)D.Subsequently, in the proximal tubules of the kidney, the 1α-hydroxylase 25(OH)D converts it to1.25(OH)D
We evaluated the effect of vitamin D supplementation in children with idiopathic hypercalciuria on 25(OH)D blood level, caciuria, development of new stones in urinary tract and bone mineral density
In a multicentre study of the pediatric population, a clear deficiency of vitamin D was found in 75–80% of children [19]
Summary
Vitamin D is a fat-soluble steroid hormone, which regulates calcium and phosphate metabolism. In Europe, the incidence of this disease is estimated at about 4% in the adult population and 1–2% in children [8,12] Both urolithiasis and hypercalciuria predispose to skeletal mineralization disorders, leading to a decreased bone density [8,9]. The identification of patients who are at risk of osteopenia and osteoporosis among patients with urolithiasis and idiopathic hypercalciuria allows the implementation of a preventive strategy that includes appropriate supplementation with vitamin D [1,14]. We evaluated the effect of vitamin D supplementation in children with idiopathic hypercalciuria on 25(OH)D blood level, caciuria, development of new stones in urinary tract and bone mineral density
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