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

Hesswani, Charles; Noureldin, Yasser A.; Elkoushy, Mohamed A.; Andonian, Sero

doi:10.5489/cuaj.3332

Cited by 13 publications

(22 citation statements)

References 17 publications

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“…We found a decline in PTH consistent with prior studies . Calcium supplements suppress PTH secretion as does vitamin D supplementation.…”

Section: Discussionsupporting

confidence: 90%

“…We found a decline in PTH consistent with prior studies. 22,31 Calcium supplements suppress PTH secretion as does vitamin D supplementation. In a previous study with 4000 IU/day of vitamin D 3 , a decline was not seen in CTX in the vitamin D groups.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19] Some studies have reported hypercalcaemia and hypercalciuria in association with calcium/vitamin D supplements which may be the aetiology of the increase in kidney stones. 12,[20][21][22][23][24][25] Here, we report on a study whose primary outcome is hypercalciuria/hypercalcaemia in response to calcium intake at its UL for those 51 + years with vitamin D intake either at the adult RDA (600-800 IU/day) or at the UL suggested by the Endocrine Society Guidelines (10 000 IU/day).…”

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confidence: 99%

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Safety of calcium and vitamin D supplements, a randomized controlled trial

Aloia

Katumuluwa

Stolberg

et al. 2018

Clinical Endocrinology

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Objective It is anticipated that an intake of vitamin D found acceptable by Endocrine Society Guidelines (10 000 IU/day) with co‐administered calcium supplements may result in frequent hypercalciuria and hypercalcaemia. This combination may be associated with kidney stones. The objective of this study was to compare the episodes of hypercalciuria and hypercalcaemia from calcium supplements co‐administered with 10 000 IU or 600 IU vitamin D daily. This design allows a comparison of the Institute of Medicine recommendation for the RDA of vitamin D along with the upper limit of calcium intake with the high intake of vitamin D suggested by the Endocrine Society. Context Harms of currently recommended high intake of vitamin D have not been studied. Design The design was a randomized controlled trial with 2 groups with evaluation every 3 months for one year: (a) CaCO3 1200 mg/day with 10 000 IU vitamin D3/day or (b) CaCO3 1200 mg/day with 600 IU vitamin D3/day. Patients This study was conducted in an ambulatory research centre in healthy, white postmenopausal women. Measurements Serum and 24‐hour urine calcium were measured. Results Hypercalcaemia and hypercalciuria occurred in both groups. At the final visit, 19/48 in the high dose D group had hypercalciuria. The odds of developing hypercalciuria were 3.6 [OR = 3.6(1.39, 9.3)] times higher in the high dose D group. The odds of developing hypercalcaemia did not differ between groups. Conclusions The safe upper level of vitamin D recommended by the Endocrine Society when accompanied by calcium supplements results in frequent hypercalciuria. The risk of kidney stones at these levels should be investigated.

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“…We found a decline in PTH consistent with prior studies . Calcium supplements suppress PTH secretion as does vitamin D supplementation.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Safety of calcium and vitamin D supplements, a randomized controlled trial

Aloia

Katumuluwa

Stolberg

et al. 2018

Clinical Endocrinology

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“…This approach will reduce renal calcium excretion and avoid risk of hypercalcemia [35]. In order to prevent renal stone formation, 24-h urinary calcium excretion should be within the sex-specific reference range or < 300 mg/24-h in men, < 250 mg/24-h in women, or < 4 mg/ kg per 24-h in both sexes [35,36]. Normal serum phosphate levels and a serum calcium-phosphate product < 55 mg 2 /dl 2 (4.4 mmol 2 / l 2 ) are recommended to decrease the risk of extraskeletal calcification, such as vascular calcification, nephrocalcinosis, and basal ganglia calcifications [37,38].…”

Section: Therapeutic Targets In Postsurgical Hypoparathyroidismmentioning

confidence: 99%

Endocrine Complications of Surgical Treatment of Thyroid Cancer: An Update

Iglesias

Díez

2017

Exp Clin Endocrinol Diabetes

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Postoperative hypoparathyroidism (HypoPT) and hypothyroidism (HypoT) are the main endocrine complications after the surgical treatment for thyroid cancer. Postsurgical HypoPT can be transient, protracted or permanent. Its frequency varies according to the underlying cervical pathology, surgical technique, and mainly the experience of the surgeon. Risk factors for HypoPT include aggressiveness of the tumor, extent of surgery, the presence of parathyroid gland in the pathologic specimen, and surgeon experience. Clinical manifestations of postsurgical HypoPT can be acute or chronic. An adequate surgical technique that minimizes trauma and preserve the vascularization of the parathyroid glands is the better procedure to reduce the risk of postoperative HypoPT. Acute hypocalcemia may be managed with intravenous or oral calcium supplements, according to the level of serum calcium and the presence of signs and symptoms. Patients with permanent HypoPT require lifelong calcium and vitamin D supplementation. Calcitriol is the vitamin D metabolite of preference because of its high activity and short half-life. Both PTH (1-34) and intact PTH (1-84) have demonstrated to be attractive options in hypoparathyroid patients who cannot maintain stable serum and urinary calcium levels with calcium and vitamin D supplementation. However, the long-term safety of these preparations has not been established. Postsurgical HypoT is an unavoidable consequence of total or near-total thyroidectomy for thyroid cancer. Replacement and suppressive therapy are necessary in these patients. Thyroid hormone suppression therapy has shown to be accompanied by a decreased risk of disease progression and recurrence; however, it may also be associated with increased risk of dysrhythmia and loss of bone mass. Therefore, the intensity of TSH suppression must be established in a personalized way after balancing risk and benefits, according to the severity of the thyroid cancer, the response to therapy, and the individual risk factors for adverse events.

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“…Over 39 months median followup, 50% of patients developed stones compared to 11% of non-hypercalciuric patients. 67 In a study of over 46 000 post-menopausal women aged 50-79 years randomized to calcium 1000 mg and 400 IU of vitamin D or placebo, there was an increased risk of nephrolithiasis, with a hazard ratio of 1.17. 68 The authors reported within the treatment group a small improvement in hip bone density, but no reduction in hip fractures, although when adherence to study protocol was considered, a reduction in hip fracture of 29% was seen.…”

Section: Vitamin Dmentioning

confidence: 99%