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Prevalence and Metabolic Abnormalities of Vitamin D-Inadequate Patients Presenting with Urolithiasis to a Tertiary Stone Clinic.
MedLine Citation:
PMID:  22035763     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To assess the prevalence and metabolic abnormalities of patients with inadequate vitamin D (VD) presenting with urolithiasis to a tertiary stone clinic in North America. MATERIAL AND METHODS: A retrospective review of consecutive patients presenting from August 2009 to January 2010 was performed. Demographic and clinical data were collected together with metabolic stone workup, including 2 24-hour urine collections and serum 25-hydroxy VD [25(OH)D]. VD inadequacy (VDI) included VD deficiency and VD insufficiency defined as 25-(OH) VD levels <20 ng/mL and 21-29 ng/mL, respectively. RESULTS: Of 101 patients, 81 (80.2%) were found to have VDI: 34 (33.7%) were deficient and 47 (46.5%) had insufficient VD. Mean age was 50.4 ±15.8 years and the mean body mass index was 28.7 ± 5.8 kg/m(2). Forty-two percent were smokers, 51% were recurrent stone formers, and 54% had positive family history of urolithiasis. Hyperparathyroidism was detected in 25.9% of patients, of which 91% of them were secondary to VDI. Hypocalcemia and hyperuricemia were found in 36% and 11% of patients, respectively. Of 81 VDI patients, 69 (85.2%) had complete 24-hour urine collections, of which 92.7% had at least one abnormality. However, only 40% of patients with normal VD had metabolic abnormalities (P <.0001). The most prevalent pattern of urinary abnormalities in VDI patients were suboptimal volume (45%), hypocitaturia (24%), hypocalciuria (33%), hypercalciuria (20%), hyperuricosuria (16%), cystinuria (5%), and hyperoxaluria (7.2%). CONCLUSIONS: In this preliminary study, patients presenting with urolithiasis were found to have a high prevalence of inadequate VD associated with abnormalities on metabolic stone work-up.
Authors:
Mohamed A Elkoushy; Ramsey Sabbagh; Bernard Unikowsky; Sero Andonian
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-27
Journal Detail:
Title:  Urology     Volume:  -     ISSN:  1527-9995     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Division of Urology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
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