Ganji Mohammad Reza, Shafii Zahra, Hakemi Monir Sadat
Department of Nephrology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2019 Jan;13(1):27-31.
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.
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.
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.
The use of vitamin D supplements in conventional dose in patients with vitamin D deficiency may not lead to increased risk of hypercalciuria.
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。
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。
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。
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。