Combined vitamin D and calcium supplementation in vitamin D inadequate patients with urolithiasis: Impact on hypercalciuria and de novo stone formation

Authors

  • Charles Hesswani Division of Urology, McGill University Health Center, McGill University, Montreal, QC, Canada http://orcid.org/0000-0002-7391-5004
  • Yasser A Noureldin 1.Division of Urology, McGill University Health Center, McGill University, Montreal, QC, Canada 2. Department of Urology, Benha University Hospital, Benha University, Benha, Egypt
  • Mohamed A Elkoushy 1. Division of Urology, McGill University Health Center, McGill University, Montreal, QC, Canada 2. Department of Urology, Suez Canal University, Ismailia, Egypt
  • Sero Andonian Division of Urology, McGill University Health Center, McGill University, Montreal, QC, Canada

DOI:

https://doi.org/10.5489/cuaj.3332

Abstract

ABSTRACT

Introduction: We examined the effect of combined vitamin D and calcium supplementation (VDCS) on urinary calcium excretion and de novo stone formation in vitamin D inadequate (VDI) urolithiasis patients.

Methods: We retrospectively reviewed the data of VDI patients (serum 25-hydroxyvitamin D<75 nmol/L) followed at a tertiary stone centre between September 2009 and December 2014. VDI patients with history of urolithiasis, who were placed on VDCS for abnormal bone mineral density or hyperoxaliuria, were included. Hypercalciuric patients and patients on thiazide diuretics were excluded. Metabolic stone workup and two 24-hour urine collections were performed before and after VDCS.

Results: In total, we inculded 34 patients, with a mean age of 54.8 years and a mean body mass index of 25.7 kg/m2. After VDCS, there was a significant increase in the mean serum 25-hydroxyvitamin D (52.0 vs. 66.4 nmol/L, p<0.001) and the mean urinary calcium excretion (3.80 vs. 5.64 mmol/d, p<0.001). Eight (23.5%) patients developed de novo hypercalciuria. After a median follow-up of 39 (range: 7-60) months, 50% of hypercalciuric patients developed stones compared with 11.5% of non-hypercalciuric patients (p=0.038).

Conclusion: This study showed a significant effect of combined VDCS on mean urinary calcium excretion, de novo hypercalciuria, and stone development in VDI patients with history of urolithiasis. Therefore, VDI urolithiasis patients receiving VDCS are advised to have monitoring with 24-hour urine collections and imaging studies. Although small, the sample size is good enough to validate the statistical outcomes. Prospective studies are needed to confirm these results.

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Author Biography

Charles Hesswani, Division of Urology, McGill University Health Center, McGill University, Montreal, QC, Canada

Medical student, 2nd year

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Published

2015-12-14

How to Cite

Hesswani, C., Noureldin, Y. A., Elkoushy, M. A., & Andonian, S. (2015). Combined vitamin D and calcium supplementation in vitamin D inadequate patients with urolithiasis: Impact on hypercalciuria and de novo stone formation. Canadian Urological Association Journal, 9(11-12), 403–8. https://doi.org/10.5489/cuaj.3332

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Section

Original Research