Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis

Malihi, Zarintaj; Wu, Zhenqiang; Stewart, Alistair; Lawes, Carlene M.M.; Scragg, Robert

doi:10.3945/ajcn.116.134981

Cited by 109 publications

(91 citation statements)

References 72 publications

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“…When combined with calcium supplements, high-dose vitamin D results in a higher incidence of hypercalcemia and hypercalciuria than calcium supplements alone. (37) Unfortunately, we did not routinely measure 24-hour urine calcium in this study. Because black Americans conserve urine calcium more efficiently, it would be expected that they would be less likely than white Americans to develop hypercalciuria.…”

Section: Discussionmentioning

confidence: 97%

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Vitamin D Supplementation in Elderly Black Women Does Not Prevent Bone Loss: A Randomized Controlled Trial

Aloia

Fazzari

Islam

et al. 2018

Journal of Bone and Mineral Research

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Black Americans have lower levels of serum 25(OH)D but superior bone health compared to white Americans. There is controversy over whether they should be screened for vitamin D deficiency and have higher vitamin D requirements than recommended by the Institute of Medicine (IOM). The purpose of this trial was to determine whether Vitamin D supplementation in elderly black women prevents bone loss. A total of 260 healthy black American women, 60 years of age and older were recruited to take part in a two-arm, double-dummy 3-year randomized controlled trial (RCT) of vitamin D versus placebo. The study was conducted in an ambulatory clinical research center. Vitamin D dose was adjusted to maintain serum 25(OH)D above 75 nmol/L. Bone mineral density (BMD) and serum were measured for parathyroid hormone (PTH), C-terminal crosslink telopeptide (CTX), and bone-specific alkaline phosphatase (BSAP) every 6 months. Baseline serum 25(OH)D was 54.8 ± 16.8 nmol/L. There was no group × time interaction effect for any BMD measurement. For all BMD measurements, except for total body and spine, there was a statistically significant negative effect of time (p < 0.001). An equivalency analysis showed that the treatment group was equivalent to the control group. Serum PTH and BSAP declined, with a greater decline of PTH in the treatment group. The rate of bone loss with serum 25(OH)D above 75 nmol/L is comparable to the rate of loss with serum 25(OH)D at the Recommended Dietary Allowance (RDA) of 50 nmol/L. Black Americans should have the same exposure to vitamin D as white Americans. © 2018 American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 97%

“…When combined with calcium supplements, high‐dose vitamin D results in a higher incidence of hypercalcemia and hypercalciuria than calcium supplements alone . Unfortunately, we did not routinely measure 24‐hour urine calcium in this study.…”

Section: Discussionmentioning

confidence: 98%

Vitamin D Supplementation in Elderly Black Women Does Not Prevent Bone Loss: A Randomized Controlled Trial

Aloia

Fazzari

Islam

et al. 2018

Journal of Bone and Mineral Research

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“…The recommended dose of vitamin D supplementation is 2000 IU per day or more depending on blood level. For those with a history of kidney stones, however, excess vitamin D intake should be avoided (Malihi et al 2016).…”

Section: Pay Attention To Physical Healthmentioning

confidence: 99%

Maintaining Health and Well-Being by Putting Faith into Action During the COVID-19 Pandemic

2020

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Anxiety and fear adversely affect the physiological systems that protect individuals from infection. This article comments on the role that religious faith and practice can play in helping individuals remain free from infection by the coronavirus and in helping to moderate the effects of infection if that should occur. The author provides six recommendations to help individuals maintain spiritual, mental, and physical resilience during these anxious times of the COVID-19 pandemic.

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“…Vitamin D receptor gene polymorphisms may influence vitamin D function, as well as its serum levels. In addition to the above, supplementation of vitamin D in humans and rats can induce hypercalciuria, renal calcification, and/or renal stones [55,56]. …”

Section: Discussionmentioning

confidence: 99%

“…However, many doctors and patients are concerned about whether vitamin D repletion will increase the risk of urolithiasis, especially in SFs [64]. A recent systematic review and meta-analysis demonstrated that long-term vitamin D supplementation resulted in increased risks of hypercalcemia and hypercalciuria, but did not increase risk of kidney stones [55]. A randomized controlled trial conducted in 21 SFs found that high-dose and low-dose vitamin D supplementation had no effect on urine calcium excretion or the supersaturation of calcium salts [65].…”

Section: Discussionmentioning

confidence: 99%

Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis

Zhang

et al. 2017

Nutrients

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Many studies compared the serum/plasma 1,25 dihydroxyvitamin D3 (1,25(OH)2D) and 25 hydroxyvitamin D3 (25(OH)D) between people with and without nephrolithiasis, and their results were conflicting. After systematically searching PubMed, Web of Science, The Cochrane Library, CNKI, and the Wanfang Database, we conducted a meta-analysis. Thirty-two observational studies involving 23,228 participants were included. Meta-analysis of these studies showed that of stone formers (SFs), calcium SFs had significantly higher concentrations of 1,25(OH)2D (weighted mean difference (WMD), 10.19 pg/mL; 95% confidence interval (CI), 4.31–16.07; p = 0.0007 and WMD, 11.28 pg/mL; 95% CI, 4.07–18.50; p = 0.002, respectively) than non-stone formers, while the levels of 25(OH)D (WMD, 0.88 ng/mL; 95% CI, −1.04–2.80; p = 0.37 and WMD, −0.63 ng/mL; 95% CI, −2.72–1.47; p = 0.56, respectively) are similar. Compared with controls and normocalciuria SFs, hypercalciuria SFs had increased circulating 1,25(OH)2D (WMD, 9.41 pg/mL; 95% CI, 0.15–18.67; p = 0.05 and WMD, 2.75 pg/mL; 95% CI, −0.20–5.69; p = 0.07, respectively) and markedly higher 25(OH)D (WMD, 5.02 ng/mL; 95% CI, 0.99–9.06; p = 0.01 and WMD, 5.02 ng/mL; 95% CI, 2.14–7.90; p = 0.0006, respectively). Normocalciuria SFs had elevated 1,25(OH)2D level (WMD, 6.85 pg/mL; 95% CI, −5.00–18.71; p = 0.26) and comparable 25(OH)D (WMD, 0.94 ng/mL; 95% CI, −3.55–5.43; p = 0.68). Sensitivity analysis generated similar results. Current evidence suggests that increased circulating 1,25(OH)2D is associated with urinary stones and a higher level of circulating 25(OH)D is significantly associated with hypercalciuria urolithiasis. Further studies are still needed to reconfirm and clarify the role of vitamin D in the pathogenesis of stones.

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Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis

Cited by 109 publications

References 72 publications

Vitamin D Supplementation in Elderly Black Women Does Not Prevent Bone Loss: A Randomized Controlled Trial

Vitamin D Supplementation in Elderly Black Women Does Not Prevent Bone Loss: A Randomized Controlled Trial

Maintaining Health and Well-Being by Putting Faith into Action During the COVID-19 Pandemic

Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis

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