Analysis of vitamin D deficiency in calcium stone-forming patients

Girón-Prieto, María Sierra; Cano-García, María del Carmen; Arrabal-Polo, Miguel Ángel; Poyatos-Andujar, Antonio; Quesada-Charneco, Miguel; Haro-Muñoz, Tomás de; Arias‐Santiago, Salvador; Arrabal‐Martín, Miguel

doi:10.1007/s11255-016-1290-3

Cited by 22 publications

(18 citation statements)

References 17 publications

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“…After full-text analysis, another 19 studies were excluded for the following reasons: 14 had no control group and no useful data, three did not provide standard deviations, and two reported duplicate data. Finally, 32 studies fulfilled our eligibility criteria and were enrolled in the meta-analysis [10,11,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47]. …”

Section: Resultsmentioning

confidence: 99%

“…The subjects were on a free or normal calcium diet in some studies [10,11,19,21,22,26,28,29,32,35,36,39,43], while restricted calcium diets were adopted in some others [24,27,31,33,34,38]. Nineteen of the included trials only tested serum/plasma 1,25(OH) 2 D [19,20,22,24,26,27,28,30,31,32,33,34,35,36,37,38,39,42,43], six only assessed 25(OH)D [18,25,40,41,44,47], and the others evaluated the two metabolites at the same time [10,11,21,22,29,45,46]. The most commonly used measurement method for 1,25(OH) 2 D and 25(OH)D was radioimmunoassay.…”

Section: Resultsmentioning

confidence: 99%

“…The most commonly used measurement method for 1,25(OH) 2 D and 25(OH)D was radioimmunoassay. Twenty studies were rated as being relatively high in quality according to the Newcastle-Ottawa Scale [18,19,21,23,24,27,28,29,30,33,35,37,38,39,40,42,43,45,46,47]. The other 12 were scored as 6 or 7, mainly due to some important baseline characteristics of the groups, such as age, sex, and/or use of vitamin D were not well matched or clearly reported [10,11,20,22,25,26,31,32,34,36,41,44].…”

Section: Resultsmentioning

confidence: 99%

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Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis

Zhang

et al. 2017

Nutrients

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Many studies compared the serum/plasma 1,25 dihydroxyvitamin D3 (1,25(OH)2D) and 25 hydroxyvitamin D3 (25(OH)D) between people with and without nephrolithiasis, and their results were conflicting. After systematically searching PubMed, Web of Science, The Cochrane Library, CNKI, and the Wanfang Database, we conducted a meta-analysis. Thirty-two observational studies involving 23,228 participants were included. Meta-analysis of these studies showed that of stone formers (SFs), calcium SFs had significantly higher concentrations of 1,25(OH)2D (weighted mean difference (WMD), 10.19 pg/mL; 95% confidence interval (CI), 4.31–16.07; p = 0.0007 and WMD, 11.28 pg/mL; 95% CI, 4.07–18.50; p = 0.002, respectively) than non-stone formers, while the levels of 25(OH)D (WMD, 0.88 ng/mL; 95% CI, −1.04–2.80; p = 0.37 and WMD, −0.63 ng/mL; 95% CI, −2.72–1.47; p = 0.56, respectively) are similar. Compared with controls and normocalciuria SFs, hypercalciuria SFs had increased circulating 1,25(OH)2D (WMD, 9.41 pg/mL; 95% CI, 0.15–18.67; p = 0.05 and WMD, 2.75 pg/mL; 95% CI, −0.20–5.69; p = 0.07, respectively) and markedly higher 25(OH)D (WMD, 5.02 ng/mL; 95% CI, 0.99–9.06; p = 0.01 and WMD, 5.02 ng/mL; 95% CI, 2.14–7.90; p = 0.0006, respectively). Normocalciuria SFs had elevated 1,25(OH)2D level (WMD, 6.85 pg/mL; 95% CI, −5.00–18.71; p = 0.26) and comparable 25(OH)D (WMD, 0.94 ng/mL; 95% CI, −3.55–5.43; p = 0.68). Sensitivity analysis generated similar results. Current evidence suggests that increased circulating 1,25(OH)2D is associated with urinary stones and a higher level of circulating 25(OH)D is significantly associated with hypercalciuria urolithiasis. Further studies are still needed to reconfirm and clarify the role of vitamin D in the pathogenesis of stones.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis

Zhang

et al. 2017

Nutrients

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“…However, the association between vitamin D status and the hematuria, another important parameter of kidney disease other than proteinuria, has not been evaluated yet. Furthermore, there are accumulating evidence that vitamin D deficiency contributes to pathologic conditions that can be presented as hematuria such as urinary stone [22], infection [23] and malignancy [24]. The present study is the first to examine this correlation using data of a nationwide population-based survey, stratified by sex and menopause status as these parameters are known to be important in analyzing the effects of vitamin D deficiency [25, 26].…”

Section: Introductionmentioning

confidence: 95%

Association between vitamin D level and hematuria from a dipstick test in a large scale population based study: Korean National Health and nutrition examination survey

Ryu

Cho

et al. 2019

BMC Nephrol

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Background Vitamin D deficiency is an important health concern because it is related to several comorbidities and mortality. However, its relationship with the risk of hematuria remains undetermined in the general population. In this study, we analyzed the association between vitamin D deficiency and hematuria. Methods We conducted cross-sectional analysis using data of participants from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2014. A total of 20,240 participants, aged ≥18 years old, were analyzed. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured in a central laboratory and hematuria was defined as ≥1+ on a dipstick test. Multivariate logistic regression was conducted to calculate the odds ratio (OR) of hematuria risk according to serum 25(OH)D quartiles, after adjusting several covariates. Results A total 3144 (15.5%) participants had hematuria. The mean 25(OH)D level was 17.4 ± 6.2 ng/mL (median, 16.6 ng/mL (interquartile range, 13.1–20.8 ng/mL)). The 3rd and 4th quartiles had a higher risk of hematuria than the 1st quartile, with adjusted ORs 1.26 (1.114–1.415) and 1.40 (1.240–1.572) in the 3rd and 4th quartiles, respectively. However, this relationship was only significant in women, not in men. When stratified analyses were conducted according to menopausal status, there was a significant increase of hematuria risk according to quartiles in postmenopausal but not in premenopausal women. Conclusion We found that vitamin D deficiency is correlated with hematuria in women, particularly after menopause. Further interventional studies are warranted to address whether correcting vitamin D deficiency can lower the risk of hematuria.

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“…It has also been shown that hypovitaminosis D may be associated with increased kidney stone formation. There is a high prevalence of vitamin D deficiency in stone formers compared to non‐stone formers . Possible explanations for this association include: secondary hyperparathyroidism in vitamin D deficiency, dietary factors (low calcium intake), increased oxidative stress or inflammation in vitamin D deficiency.…”

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confidence: 99%

Vitamin D and kidney stones – is there an association?

et al. 2019

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Vitamin D deficiency, by UK guidelines, is defined as a serum level of <25 nmol/L 25(OH) vitamin D. Borderline cases of deficiency are common in the UK. Indeed, a lack of vitamin D is so common that The National Institute for Health and Care Excellence recommends that, to prevent vitamin D deficiency, every adult living in the UK should take a daily supplement containing 400 IU (10 lg) of vitamin D throughout the year, in order to prevent poor musculoskeletal health.Whilst vitamin D supplementation is important for bone health in vitamin D deficiency, particularly in symptomatic individuals, over-treatment with high doses can lead to hypervitaminosis D with adverse outcomes. Vitamin D intoxication can result in hypercalcaemia, hypercalciuria, gastrointestinal tract disturbances, and calcification of soft tissues (the heart, the lungs, and the kidney) and in severe cases, fatalities. Intakes of just 10-times the recommended nutritional intake can result in toxicity. Vitamin D is catabolised in the liver and the breakdown products are secreted into the bile, and eliminated in faeces and only 2-4% of the breakdown products are eliminated in urine. The 25(OH) vitamin D metabolite, produced in liver, is secreted and is bound to vitamin D binding protein in serum and shuttled to sites of metabolism, action, and catabolism.Several studies have attempted to find an association between serum concentrations of vitamin D, hypercalciuria, and risk of renal stone formation. In the Health Professionals Followup Study (HPFS), for example, there was no statistically significant association between intake and risk of stones [1]. In this case, participants were either categorised based on total or supplemental vitamin D intake. Multivariate logistic regression was applied in this study.Other studies have described positive associations in hypercalciuric stone formers. This subset of stone formers was shown to have higher serum concentrations of 25(OH) vitamin D compared to stone formers with normal calcium excretion, and non-stone formers [2]. The hypercalciuric stone formers also had significantly higher serum 1,25(OH)2 vitamin D or calcitriol (the active hormone that maintains calcium and phosphate homeostasis) and there is a correlation between circulating calcitriol levels and stone formers with idiopathic hypercalciuria. The explanation for the higher calcitriol levels in this sub-group of stone formers may be related to several mechanisms including, increased sensitivity to calcitriol due to vitamin D receptor gene polymorphisms resulting in increased calcium absorption across the enterocytes and reduced catabolism of calcitriol due to genetic variations in genes that control the catabolism of calcitriol. In the kidney, the 24-hydroxylase enzyme limits the amount of 1,25(OH)2 synthesis by increasing its catabolism to 1,24,25(OH)3 vitamin D. The 24-hydroxylase also shunts 25(OH) vitamin D away from 1a-hydroxylase. Both 24-hydroxylated products are biologically inactive. This system provides a means of negative feedback of the...

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Analysis of vitamin D deficiency in calcium stone-forming patients

Abstract: Calcium stone-forming patients have lower mean levels of vitamin D and a higher percentage of hypovitaminosis D than in non-stone-forming patients. This was only related to increased iPTH levels, with urine calcium and other lithogenic parameters having no obvious effect.

Cited by 22 publications

References 17 publications

Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis

Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis

Association between vitamin D level and hematuria from a dipstick test in a large scale population based study: Korean National Health and nutrition examination survey

Vitamin D and kidney stones – is there an association?

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