Effect of vitamin D supplementation on 24-hour urine calcium in patients with calcium Urolithiasis and vitamin D deficiency

Abstract

Purpose: 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.

A Path Analysis To Investigate The Interaction Between Serum, Urinary And Demographic Factors Influencing Urine Calcium In Kidney Stone Formers

“…Other studies failed to observe any correlations between 25(OH)D and urinary calcium excretion (19)(20)(21). The results of our previous study (24) showed that the 24-U Ca increased in vitamin D supplemented patients, which was not associated with serum 25(OH)D or PTH changes. Other results of that study suggested that the increase in 24-U Ca might be due to other factors such as dietary sodium and protein intake.…”

Prevalence of vitamin D3 deficiency in patients with type 2 diabetes and proteinuria

“…Although data suggest that vitamin D supplements increase the risk of hypercalcemia by increasing intestinal calcium absorption, episodes of hypercalciuria are not correlated with hypercalcemia 31 . In a study by Tacheri et al 32 , an increase in calcium in urine from 3.74 mmoL/24 h to 5.7 mmoL/24 h was registered 32 , while in our study after the initial increase in calcium urinary values from 3.34 mmoL/24 h to 4.5 mmoL/24 h, a stagnation of its values was registered with a slight decrease by the end of monitoring. In this research, it was concluded that despite the increase in calciuria during supplementation with vitamin D, it was not correlated with the increase in vitamin D values or changes in PTH values 32 .…”

Effect of Vitamin D Treatment on Dynamics of Stones Formation in the Urinary Tract and Bone Density in Children with Idiopathic Hypercalciuria

“…There is controversy on the effect of vitamin D administration on the urolithiasis activity. Earlier reports suggested the possibility of negative impact of vitamin D supplementation on the activity of urolithiasis, and vitamin D treatment in these patients was, therefore, contraindicated [20,21].…”