Increased Incidence of Nephrolithiasis (N) in Lifeguards (LG) in Israel

Better, Ori S.; Shabtai, Moshe; Kedar, Sachin; Melamud, Aleksandr; Berenheim, J; Chaimovitz, Cidio

doi:10.1007/978-1-4615-9167-2_51

Cited by 36 publications

(21 citation statements)

References 5 publications

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“…Clinicians should also be aware of described toxicities from high doses of vitamin D. These have been comprehensively described in the literature and include hypercalcemia, hypercalciuria, nephrocalcinosis, and even renal impairment. 39,40 In summary, although this study did not meet its primary endpoint of demonstrating significant changes in pain or bone turnover markers, the effects of high physiologic doses of vitamin D did show some indication of clinical benefit, as manifested by a reduction in the number of sites of pain. Furthermore, this therapy helped unmask underlying endocrinopathy, specifically primary hyperparathyroidism.…”

Section: Discussionmentioning

confidence: 78%

A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D₃ in breast cancer patients with bone metastases

Amir

Simmons

Freedman

et al. 2009

Cancer

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BACKGROUND: Vitamin D deficiency has potential roles in breast cancer etiology and progression. Vitamin D deficiency has also been associated with increased toxicity from bisphosphonate therapy. The optimal dose of vitamin D supplementation is unknown, but daily sunlight exposure can generate the equivalent of a 10,000-IU oral dose of vitamin D 3 . This study therefore aimed to assess the effect of this dose of vitamin D 3 in patients with bone metastases from breast cancer. METHODS: Patients with bone metastases treated with bisphosphonates were enrolled into this single-arm phase 2 study. Patients received 10,000 IU of vitamin D 3 and 1000 mg of calcium supplementation each day for 4 months. The effect of this treatment on palliation, bone resorption markers, calcium metabolism, and toxicity were evaluated at baseline and monthly thereafter. RESULTS: Forty patients were enrolled. No significant changes in bone resorption markers were seen. Despite no change in global pain scales, there was a significant reduction in the number of sites of pain. A small but statistically significant increase in serum calcium was seen, as was a significant decrease in serum parathyroid hormone. Treatment unmasked 2 cases of primary hyperparathyroidism, but was not associated with direct toxicity. CONCLUSIONS: Daily doses of 10,000 IU vitamin D 3 for 4 months appear safe in patients without comorbid conditions causing hypersensitivity to vitamin D. Treatment reduced inappropriately elevated parathyroid hormone levels, presumably caused by long-term bisphosphonate use. There did not appear to be a significant palliative benefit nor any significant change in bone resorption. Cancer 2010;116:284-91.

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Section: Discussionmentioning

confidence: 78%

A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D₃ in breast cancer patients with bone metastases

Amir

Simmons

Freedman

et al. 2009

Cancer

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“…This variation is attributed to changes in sunlight exposure and has been correlated with variation in urinary calcium excretion [13]. A case in point is the study by Better et al [18], which showed elevated serum 25(OH)D levels and hypercalciuria in a cohort of adult lifeguards in Israel during the summer months. Despite the presence of expected, significant seasonal variation in sunlight (Fig.…”

Section: Discussionmentioning

confidence: 96%

Lack of seasonal variations in urinary calcium/creatinine ratio in school-age children

et al. 2004

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Seasonal variations in urinary calcium excretion have been observed in adults and are thought to be due to seasonal changes in sunlight exposure, which results in fluctuation of blood levels of 25-hydroxyvitamin D. The goal of the present study was to explore the possible effect of season on urinary calcium/creatinine ratio (UCa/Cr) in healthy school children. We studied 65 healthy Caucasian children aged 5.1-14.6 years (mean+/-SD 9.6+/-2.0, median 9.7 years). Random, non-fasting urine samples were collected from each participant between the 1st and 5th days of the month for 16 successive months and analyzed for UCa/Cr. In parallel, meteorological data, which included average monthly temperature and average monthly UV index, were collected for the whole study period. A mathematical model describing the monthly mean values of UCa/Cr as a sine function was used to determine the presence of seasonal variation. The observed maximum mean UCa/Cr, 0.092 mg/mg (0.260 mmol/mmol), occurred in the late summer months (August/September) and minimum mean UCa/Cr, 0.083 mg/mg (0.235 mmol/mmol), occurred in mid-winter (January/February), reflecting an infinitesimal and statistically insignificant change. Moreover, both values were well within the previously established normal range for UCa/Cr of

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“…Conditions for these facilities can include incidents of high temperatures, high humidity, a lack of adequate ventilation for indoor aquatic facilities, and, of course, exposure to direct sun at outdoor aquatic facilities. Better et al (1980) noted that lifeguards working outdoors are exposed to intense heat from the sun on their entire body for a good part of the calendar year. Although we tend to think lifeguards working in external environments are at greater risk when it comes to heat-related issues such as dehydration, our study did not reveal significant differences in dehydration between indoor and outdoor aquatic facilities.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Inadequate Hydration Levels in Aquatic Safety Personnel: A Pilot Study

Ramos¹,

Anderson²,

Fletcher³

2015

IJARE

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Increased Incidence of Nephrolithiasis (N) in Lifeguards (LG) in Israel

Cited by 36 publications

References 5 publications

A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D₃ in breast cancer patients with bone metastases

A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D₃ in breast cancer patients with bone metastases

Lack of seasonal variations in urinary calcium/creatinine ratio in school-age children

Prevalence of Inadequate Hydration Levels in Aquatic Safety Personnel: A Pilot Study

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Increased Incidence of Nephrolithiasis (N) in Lifeguards (LG) in Israel

Cited by 36 publications

References 5 publications

A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D3 in breast cancer patients with bone metastases

A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D3 in breast cancer patients with bone metastases

Lack of seasonal variations in urinary calcium/creatinine ratio in school-age children

Prevalence of Inadequate Hydration Levels in Aquatic Safety Personnel: A Pilot Study

Contact Info

Product

Resources

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A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D₃ in breast cancer patients with bone metastases

A phase 2 trial exploring the effects of high‐dose (10,000 IU/day) vitamin D₃ in breast cancer patients with bone metastases