MP24-11 LONG-TERM TREATMENT OF VITAMIN D INSUFFICIENCY OR DEFICIENCY IN POSTMENOPAUSAL WOMEN WITH HYPERCALCIURIA DOES NOT INCREASE URINARY CALCIUM EXCRETION

Abstract

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology II1 Apr 2018MP24-11 LONG-TERM TREATMENT OF VITAMIN D INSUFFICIENCY OR DEFICIENCY IN POSTMENOPAUSAL WOMEN WITH HYPERCALCIURIA DOES NOT INCREASE URINARY CALCIUM EXCRETION Kristina L. Penniston, Karen E. Hansen, Abigail C. Staples, Stephen Y. Nakada, and R. Allan Jhagroo Kristina L. PennistonKristina L. Penniston More articles by this author , Karen E. HansenKaren E. Hansen More articles by this author , Abigail C. StaplesAbigail C. Staples More articles by this author , Stephen Y. NakadaStephen Y. Nakada More articles by this author , and R. Allan JhagrooR. Allan Jhagroo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.764AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Vitamin D (VD) repletion in calcium (Ca) stone formers is sometimes questioned, especially if long-term and/or in those with hypercalciuria (>250 mg/d). We assessed the effect of VD repletion for 1 year on urinary Ca excretion. METHODS The study was randomized, double-blind, placebo-controlled, and IRB-approved. Postmenopausal women with low VD status [serum 25(OH)D <30 ng/mL; n=90; 61±6 y; BMI 30.8±6.8) were randomized to placebo, low-dose (LD) VD (800 IU daily), or high-dose (HD) VD (50,000 IU for 15 d followed by 50,000 IU twice/month for 1 y). Prefilled 31-day pill boxes were dispensed; remaining capsules were counted at study visits (60, 120, & 365 days) to assess compliance. Multiple-day weighed diet records prior to intervention were completed by all to establish individuals′ usual nutritional intake. To reduce dietary confounders in 24-h urine collections, dietary intake was reproduced for energy and nutrient composition for each participant during her baseline and 1 y visits, during which 24-h urine collections were collected. RESULTS Median baseline urinary Ca excretion was 209 mg/d. Compliance with treatment was estimated at approximately 100% across all arms. Overall, urinary Ca excretion was unchanged at 1 y (228±70 to 219±92 mg/d; P=0.25, paired t-test). Only women in the HD group achieved 25(OH)D ≥30 ng/mL (21±3 to 56±12 ng/mL; P<0.001). Despite this rise in VD status, urinary Ca excretion did not increase in this group (256±86 to 250±131 mg/d; P=0.74). Nor did urinary Ca excretion change in the other groups (P≥0.27 for within-group pairwise comparisons from baseline to 1 y). Among hypercalciuric women across all groups (figure; n=28), Ca excretion did not change (312±60 to 273±130 mg/d; P=0.07), but tended to be lower. Hypercalciuria was resolved at 1 y in 40%, 57%, and 50% in HD, LD, and placebo groups, respectively. The incidence of new hypercalciuria at 1 y was 6.7%, 19%, and 12%, respectively. CONCLUSIONS Despite a significant rise in VD status, VD repletion at 50,000 IU twice monthly for 1 y, following a loading dose, did not increase urinary Ca excretion in postmenopausal women with or without hypercalciuria. VD repletion at lower doses also did not increase urinary Ca, and goal VD status was not achieved. Evidence suggests the risk for hypercalciuria is low following VD repletion in patients with low VD status. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e294 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Kristina L. Penniston More articles by this author Karen E. Hansen More articles by this author Abigail C. Staples More articles by this author Stephen Y. Nakada More articles by this author R. Allan Jhagroo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...