Kidney Stone Clinic, University Health Network, Toronto, Ont., Canada.
Nephron Clin Pract. 2012;122(3-4):134-8. doi: 10.1159/000351377. Epub 2013 May 23.
Data regarding the prevalence of 25-hydroxyvitamin D (25(OH)D) insufficiency in patients with nephrolithiasis, and the effects of vitamin D supplementation on parathyroid hormone (PTH) are few and conflicting. In this article, we examined the prevalence of vitamin D insufficiency and deficiency in 236 recurrent kidney stone formers and the correlation of vitamin D levels with other parameters of stone formation. The prevalent stone composition was calcium oxalate (80.4%) and uric acid (16.45%). One third of stone formers had vitamin D insufficiency and a quarter of them high PTH levels (PTH >7.5 pmol/l) with normal serum (total and ionized) calcium values. Predictor of high PTH was low 25(OH)D level (r = 0.989, r(2) = 0.977, p < 0.001). Stone formers with hypercalciuria had higher 25(OH)D values (72.26 ± 4.21 vs. 59.29 ± 1.76, p = 0.0013) compared to stone formers with urine calcium within normal ranges. Further studies are needed in order to better define the consequences of vitamin D insufficiency and to evaluate the impact of the therapeutic interventions in this cohort.
关于肾结石患者 25-羟维生素 D(25(OH)D)不足的患病率,以及维生素 D 补充对甲状旁腺激素(PTH)的影响的相关数据很少且存在矛盾。在本文中,我们检查了 236 例复发性肾结石患者中维生素 D 不足和缺乏的患病率,以及维生素 D 水平与结石形成的其他参数的相关性。常见的结石成分是草酸钙(80.4%)和尿酸(16.45%)。三分之一的结石形成者存在维生素 D 不足,四分之一的患者存在高甲状旁腺激素水平(PTH>7.5 pmol/l),但血清(总钙和离子钙)值正常。高 PTH 的预测因子是低 25(OH)D 水平(r = 0.989,r² = 0.977,p < 0.001)。尿钙在正常范围内的结石形成者比高钙尿症的结石形成者具有更高的 25(OH)D 值(72.26 ± 4.21 与 59.29 ± 1.76,p = 0.0013)。需要进一步的研究来更好地定义维生素 D 不足的后果,并评估该队列中治疗干预的影响。