PS-244a Is Vitamin D Deficiency A Risk Factor For Urinary Tract Infection In Children?

Abstract

After 48 h of treatment a significant decline in bicarbonate levels (from 35,3 ± 4,7 to 31,1 ± 3,9 mmol/L, p < 0,001), pH (from 7,45 ± 0,05 to 7,41 ± 0,06, p < 0,001), and PCO2 (from 52.9 ± 10 to 51,2 ± 10 mmHg, p = 0,002) were found, whereas anion GAP increased (from 6,8 ± 9,8 to 8,7 ± 3,8, p = 0,001). Mechanical ventilation was in use in 102 patients, (31,6% were extubated during acetazolamide treatment).Average Acetazolamide dose was 8,46 mg/Kg/day. None of the patients suffered from serious side-effects attributable to Acetazolamide. Conclusions Acetazolamide treatment improved metabolic alkalosis secondary to diuretic treatment in critically ill children, contributing to a decrease in PaCO2. Enteral administration was effective and well tolerated without serious adverse effects. Background and aims There is increasing evidence that vitamin D deficiency plays an important role in susceptibility to infections. We aimed to examine whether there is any association between serum levels of 25-hydroxy vitamin D (25(OH)D3) and urinary tract infections (UTI) among children. Methods Serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), parathormone (PTH) and serum 25(OH)D3 levels were measured in 82 children aged 2 months to 12 years with first episode of UTI, not having any risk factor for UTI, and 64 healthy control children. The age, gender, weight, height, fever, vitamin D or calcium supplementation, urinalysis and urine culture were recorded. Results The serum levels of 25(OH)D3 were significantly lower in the study group compared to healthy control group (11.69 ± 3.25 ng/mL vs. 27.57 ± 4.72 ng/mL; p < 0.001). There was statistically significant difference in serum 25(OH)D3 levels between the patients with upper UTI compared to the patients with lower UTI (8.63 ± 2.76 ng/mL vs. 14.22 ± 2.97 ng/mL; p < 0.001). The serum levels of 25(OH)D3 were significantly lower in girls compared to the boys in the study group (10.91 ± 3.42 ng/mL vs. 13.20 ± 4.38 ng/mL; p < 0.001). Multivariate analysis showed that a serum 25(OH)D3 level of < 15 ng/mL (odds ratio 3.50, 95% confidence interval 1.62-7.57; p = 0.001) was associated with UTI in children. Conclusions Our results suggest that vitamin D deficiency is a risk factor for UTI in children and low serum level of vitamin D in girls is one of the reason for prone to UTI. PS-244a IS VITAMIN D DEFICIENCY

The effect of breastfeeding and vitamin D status on the susceptibility of infants to infections

“…However, in the same study a prevalence of infection was reported higher in girls than boys, which is a known risk factor, and agrees with our observations as more than half of our patients (59%) were female too. This is in accordance with some studies that found significantly lower 25 (OH)D levels in children with UTI compared to controls and supports that VitD deficiency is a risk factor for UTI and especially in girls (12,(197)(198)(199).…”

Serum Vitamin D Level and the Risk of Urinary Tract Infection in Children: A Systematic Review and Meta-Analysis

“…Four of the six included studies showed that serum levels of vitamin D were significantly lower in children with urinary tract infection than that in controls ( 14 – 16 , 18 ). One study by Noorbakhsh et al ( 17 ) showed no significant differences between the patient and control groups.…”

“…Although we did not examine the association between age and sex with plasma levels of vitamin D and the risk of UTI in this study, most studies suggest that plasma vitamin D levels vary with age and sex and it could be one of the limitations of this study. Shalaby et al (15), Tekin et al (14), and Georgieva et al (16) showed that serum 25(OH)D3 levels in girls were significantly lower than boys. This difference in this period of life can be due to malnutrition, inadequate exposure to sunlight and the presence of differencein sex chromosomes (22).…”

“…Interestingly, data from Figure 2 show that the values obtained for vitamin D in the two Mahyar et al (11) and Noorbakhsh et al (17) studies have a protective role against UTI. However, other data show that the values of vitamin D in other studies act as a risk factor for UTI (12,14,15,18), in other words, low levels of vitamin D are known as a risk factor for UTI. Sum up, analysis of the all groups showed that serum levels of vitamin D can be a risk factor for UTI (SMD: 0.797; 95% CI 0.500-1.094, p < 0.001; Q-value = 269.2, df = 5, I 2 = 98.1, p < 0.001).…”

“…It was reported that supplementation with vitamin D might prevent UTI (9). In addition to, several studies demonstrated that the low level of 25(OH)D may be a risk factor for UTI (11)(12)(13)(14)(15). Beside the growing evidence on the role of vitamin D supplementation in prevention and treatment of UTI in children, no study has systemically evaluated the association between serum vitamin D level and risk of UTI in children.…”