Evaluation of the relationship between vitamin D levels and prevalence of urinary tract infections in children

Abstract

Urinary tract infection (UTI) is associated with increased health burden among paediatric patients. Vitamin D is known for its immunoregulatory effects, particularly antimicrobial activity. The aim of this study was to determine the relationship between vitamin D levels and UTIs in children referred to a hospital in Khorramabad, Iran. This case–control study was conducted on 258 children aged between 2 and 14 years; 44 children with UTI and 214 healthy children were enrolled. Patients were tested for UTI on the basis of signs and symptoms, and urine culture and analysis. Vitamin D levels were measured in children in both groups. According to the results, the two groups were significantly different in terms of sex (p 0.007). There was no significant difference between the mean vitamin D among the two groups. Vitamin D levels were not related to UTI by multivariate logistic regression. The relationship between the level of vitamin D and the incidence of UTI in children in accordance with age and sex had an odds ratio of 0.99, indicating that for a 1-unit increase in vitamin D, the odds of having a UTI decreased by 1, a correlation which was not statistically significant. According to the findings of this study, no significant correlation was found between UTI and vitamin D levels. However, the prevalence of UTI was higher in girls than boys.

Vitamin D Status and Its Role in First-Time and Recurrent Urinary Tract Infections in Children: A Case-Control Study

“…Vitamin D levels presented a descending trend with thriving in our study, but only in children diagnosed with UTI. This finding is inconsistent with other studies evolving around UTI in children so far, which have not found any significant correlation between age and vitamin D levels [15,34]. The children included in our study benefited from continuous vitamin D prophylaxis until the age of two.…”

“…Contrarily to our findings, a study conducted by Tekin et al, which also reported a higher percentage of girls among patients with UTI, claimed that female sex also exhibited lower serum 25(OH)D values [38]. Multivariate analysis also confirmed that female sex represented a risk factor for UTIs, in conjunction with low 25(OH)D levels, similarly to another study evaluating the relationship between vitamin D deficiency and UTIs [34]. Still, sex has also been compared separately on age groups.…”

The serum vitamin D levels in children with urinary tract infection: a case–control study

“…The motility of macrophages and their activity are increased by vitamin D. Vitamin D is converted to the active form by macrophages, and the active vitamin D3 regulates the gene expression of antimicrobial peptides that are important for the defense mechanism [ 9 ]. Besides the influence on the immune system, vitamin D can affect bacterial clearance [ 3 ]. Epithelial cell-derived mediators, including antimicrobial peptides, such as α- and β-defensins and cathelicidin, have a profound effect on urinary tract defense.…”

“…UTI may have acute and chronic complications in children compared to adults, which usually has a benign course [ 2 ]. It occurs in 1% of boys and up to 5% of girls and is more frequent than bacterial meningitis, otitis media and pneumonia [ 3 ]. A large number of children with symptomatic urinary tract infections are in the first decade of life and are prone to kidney scars and subsequent possible complications such as growth retardation, arterial hypertension, proteinuria and finally, chronic renal failure.…”

“…The severity of a urinary tract infection is determined by a variety of factors, including the pathogen and the host’s immune response [ 4 ]. Up to 90% of UTI is caused by Escherichia.coli [ 3 ].…”