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补充维生素D与结石形成者高钙尿症风险

Vitamin D Supplementation and Risk of Hypercalciuria in Stone Formers.

作者信息

Ganji Mohammad Reza, Shafii Zahra, Hakemi Monir Sadat

机构信息

Department of Nephrology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Kidney Dis. 2019 Jan;13(1):27-31.

Abstract

INTRODUCTION

Whether administrating of vitamin D supplements increases the risk of hypercalciuria is still unanswered. The aim of the present study was to determine whether use of vitamin D supplementation might increase the risk of hypercalciuria.

METHODS AND MATERIALS

This interventional study was conducted on 30 who suffered from vitamin D insufficiency and deficiency and also had a history of nephrolithiasis. The patients were treated with vitamin D supplement (50000 units per week for 2 months and then every 2 weeks until the end of the 3rd month). Serum and urinary biomarkers were measured at baseline and 3 months after start of vitamin D therapy.

RESULTS

Administrating vitamin D supplement for 3 months led to a significant increase in serum level of 25-hydroxyvitamin D from 10.4 ± 4.2 ng/mL to 44.0 ± 10.7 ng/mL (P < .001). Also, the median level of serum parathyroid hormone was significantly reduced from 53 ng/L (interquartile range, 22 ng/L to 163 ng/L) to 38 ng/L (interquartile range, 16 ng/L to 102 ng/L; P < .001). There was also a significant increase in urinary citrate after using vitamin D supplement compared with the baseline from 341 mg (interquartile range, 90 mg to 757 mg) to 411 mg (interquartile range, 115 mg to 1295 mg; P = .045). Comparing biochemical parameters between the groups who developed 15% and greater and less than 15% increase in urinary calcium showed no significant difference after treatment.

CONCLUSIONS

The use of vitamin D supplements in conventional dose in patients with vitamin D deficiency may not lead to increased risk of hypercalciuria.

摘要

引言

补充维生素D是否会增加高钙尿症的风险仍未得到解答。本研究的目的是确定补充维生素D是否会增加高钙尿症的风险。

方法和材料

本干预性研究对30名维生素D不足和缺乏且有肾结石病史的患者进行。患者接受维生素D补充剂治疗(每周50000单位,持续2个月,然后每2周一次,直至第3个月末)。在基线和维生素D治疗开始3个月后测量血清和尿液生物标志物。

结果

补充维生素D 3个月导致血清25-羟基维生素D水平从10.4±4.2 ng/mL显著升高至44.0±10.7 ng/mL(P<.001)。此外,血清甲状旁腺激素的中位数水平从53 ng/L(四分位间距,22 ng/L至163 ng/L)显著降至38 ng/L(四分位间距,16 ng/L至102 ng/L;P<.001)。与基线相比,补充维生素D后尿枸橼酸盐也显著增加,从341 mg(四分位间距,90 mg至757 mg)增至411 mg(四分位间距,115 mg至1295 mg;P=.045)。比较尿钙增加15%及以上和增加不足15%的两组之间生化参数,治疗后无显著差异。

结论

维生素D缺乏患者使用常规剂量的维生素D补充剂可能不会增加高钙尿症的风险。

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