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维生素 D 补充对伴有维生素 D 缺乏的钙结石患者 24 小时尿钙的影响。

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

机构信息

Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int Braz J Urol. 2019 Mar-Apr;45(2):340-346. doi: 10.1590/S1677-5538.IBJU.2018.0522.

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.

摘要

目的

高钙尿症是钙肾结石形成的危险因素之一(最常见的尿路结石类型)。尽管维生素 D 缺乏在尿路结石患者中很常见,但维生素 D 补充对这些患者尿液钙的影响仍不清楚。

材料和方法

在这项回顾性研究中,分析了 26 例接受每周 50000IU 维生素 D 治疗 8-12 周的复发性钙肾结石和维生素 D 缺乏症患者的医学和实验室检查记录。评估了 24 小时尿钙(24-h Ca)、血清 25-羟维生素 D(25(OH)D)、血清甲状旁腺激素(PTH)、其他 24 小时尿代谢物和计算的草酸钙(CaOxSS)、磷酸钙(CaPSS)和尿酸(UASS)相对过饱和度的变化。此外,评估了 24-h Ca 变化与其他上述变量之间的相关性。

结果

维生素 D 补充后血清 25(OH)D 和 24-h Ca 增加,而血清 PTH 降低(p<0.001,所有分析)。24 小时尿钠和尿素水平显著增加(p=0.005 和 p=0.031)。CaOxSS 和 CaPSS 水平增加,但变化不显著(p=0.177 和 p=0.218)。24-h Ca 变化与血清 25(OH)D 或 PTH 之间无相关性。

结论

本研究结果表明,尽管维生素 D 补充患者的尿钙增加,但这种增加与血清维生素 D 增加无关,可能是由于饮食等其他因素。需要进一步的随机临床试验考虑与尿钙相关的其他因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ece/6541149/664f99df1e0c/1677-6119-ibju-45-02-0340-gf01.jpg

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