Calcium and Vitamin D Supplementation and Their Association with Kidney Stone Disease: A Narrative Review

Abstract

Kidney stone disease is a multifactorial condition influenced by both genetic predisposition and environmental factors such as lifestyle and dietary habits. Although different monogenic polymorphisms have been proposed as playing a causal role for calcium nephrolithiasis, the prevalence of these mutations in the general population and their complete pathogenetic pathway is yet to be determined. General dietary advice for kidney stone formers includes elevated fluid intake, dietary restriction of sodium and animal proteins, avoidance of a low calcium diet, maintenance of a normal body mass index, and elevated intake of vegetables and fibers. Thus, balanced calcium consumption protects against the risk for kidney stones by reducing intestinal oxalate availability and its urinary excretion. However, calcium supplementation given between meals might increase urinary calcium excretion without the beneficial effect on oxalate. In kidney stone formers, circulating active vitamin D has been found to be increased, whereas higher plasma 25-hydroxycholecalciferol seems to be present only in hypercalciuric patients. The association between nutritional vitamin D supplements and the risk for stone formation is currently not completely understood. However, taken together, available evidence might suggest that vitamin D administration worsens the risk for stone formation in patients predisposed to hypercalciuria. In this review, we analyzed and discussed available literature on the effect of calcium and vitamin D supplementation on the risk for kidney stone formation.

The association between caffeine intake and risk of kidney stones: A population-based study

“…The majority of stones (more than 80%) are composed of calcium oxalate (CaOx) mixed with calcium phosphate (CaP) (4,27). Previous study also indicated the importance of calcium balance on kidney stones (28). Although caffeine has the ability to increase the urinary excretion of calcium (29,30), the negative association between caffeine intake and urinary supersaturation of calcium oxalate and uric acid might explain the protective effect of caffeine on kidney stones (17).…”

A Comparative Study of Stone Re-Treatment after Lithotripsy

“…In contrast, patients with a stone size less than 0.5 cm are likely to spontaneously pass the stones under surveillance if patients experience only minor symptoms. Additionally, factors related to the location, such as food, environment, and hospital care, can also differ across countries and should always be considered [35][36][37][38][39][40].…”

“…Analyses with both univariate and multivariate Cox proportional hazards regression models showed a significant risk, with an HR of 1.36 and p < 0.001 (Tables 2 and 3). It is well known that hypertension, diabetes mellitus, heart failure, stroke, and liver cirrhosis are all highly corelated with excessive body weight, and obesity is one of the factors of renal stone formation [34,[36][37][38][39][40]49,50]. Indeed, for the other diseases, i.e., chronic kidney disease, hyperuricemia, cancer, urinary tract infections, hypercalcemia/hypercalciuria, etc., should be also taken into consideration, and they could be related to kidney stone formation; however, we only had limited authority access to the National Health Insurance Research Database in Taiwan, which is the limitation of present study.…”

Bone Fragility in Chronic Kidney Disease Stage 3 to 5: The Use of Vitamin D Supplementation

“…This was similarly the case observed in the D2D study where prediabetic patients with a baseline serum 25(OH)D concentration of 28 ng/mL received 4000 IU vitamin D3 daily for two years [ 84 ], and in the VIDA study, where subjects with a mean baseline 25(OH)D of 24.8 ng/mL received 100,000 IU vitamin D3 monthly for 3.3 years [ 85 ]. An exception may concern some patients predisposed to hypercalciuria in whom vitamin D administration might worsen the risk of stone formation [ 86 ]. The circulating concentration of FGF-23 increases as renal function declines in CKD patients [ 87 ].…”