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Carugo S, Vescini F, Giusti A, Mauro GL, Tafaro L, Festuccia F, Muraca L, Menè P, Rossini M. The essential role of combined calcium and vitamin D supplementation in the osteoporosis scenario in italy: Expert opinion paper. Arch Osteoporos 2024; 19:99. [PMID: 39438361 PMCID: PMC11496317 DOI: 10.1007/s11657-024-01451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 09/23/2024] [Indexed: 10/25/2024]
Abstract
An Italian multidisciplinary working group discussed the current Italian scenario of osteoporosis management during a meeting and highlighted the essential role of calcium and vitamin D supplementation in the prevention of fragility fractures. PURPOSE This paper aims to review and discuss data on calcium and vitamin D requirements and the role of combined calcium and vitamin D supplementation in the treatment of patients with osteoporosis. METHODS The discussion of the experts covered literature data on calcium and vitamin D supplementation, gaps in the diagnosis and treatment of osteoporosis, and the role of the primary care physician in identifying and treating patients with osteoporosis. Articles for consideration were identified through PubMed searches using different combinations of pertinent keywords. RESULTS The discussion highlighted that insufficient calcium or vitamin D intake increases the risk of fragility fractures. The experts also drew attention to the essential role of calcium and vitamin D supplementation in achieving an anti-fracture effect and supporting the efficacy of anti-osteoporotic agents without increasing nephrolithiasis and cardiovascular risks. In addition, the discussion underlined the role of the primary care physician in the initial clinical approach to patients with osteoporosis. CONCLUSIONS The experts believe that efficient treatment for patients with osteoporosis should include calcium and vitamin D supplementation to achieve adequate levels that are able to inhibit the parathyroid hormone and bone resorption.
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Affiliation(s)
- Stefano Carugo
- Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Vescini
- Endocrinology Unit University Hospital of Udine, Udine, Italy
| | - Andrea Giusti
- Division of Internal Medicine, Department of Medicine & Cardiology, "Villa Scassi" Hospital, Genoa, Italy, ASL3, 16132, Genoa, Italy
| | - Giulia Letizia Mauro
- Department of Precision Medicine in the Medical, Surgical and Critical Care Area (Me.Pre.C.C.), University of Palermo, 90127, Palermo, Italy
| | - Laura Tafaro
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | | | - Lucia Muraca
- Department of Primary Care, ASP Catanzaro, 88100, Catanzaro, Italy
| | - Paolo Menè
- Division of Nephrology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Rossini
- Department of Medicine, Rheumatology Unit, University of Verona, Verona, Italy.
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Yan F, Liu J, Tao J, Wu L, Yang J, Jing S. Causality between ankylosing spondylitis and urolithiasis in European Populations: A Mendelian randomization analysis. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102750. [PMID: 39305997 DOI: 10.1016/j.fjurol.2024.102750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/10/2024] [Accepted: 09/16/2024] [Indexed: 10/04/2024]
Abstract
BACKGROUND Ankylosing spondylitis (AS) is an inflammatory condition affecting the spine. Observational studies have suggested a heightened risk of urolithiasis in AS patients. However, due to the inherent limitations of observational research, the causal relationship between the two remains to be determined. OBJECTIVE Utilizing the Mendelian randomization analysis approach, this study sought to explore the causal link between AS and urolithiasis. METHODS Data from genome-wide association studies were employed for analysis. Mendelian randomization analyses were conducted using the IVW, MR-Egger, Weighted Median, and Weighted Mode methods. Heterogeneity tests, sensitivity analyses, and pleiotropy analyses were also performed. RESULTS The causality between AS and urolithiasis was supported by the IVW (P=.02), Weighted Median (P=.006), and Weighted Mode (P=.01) methods. The MR-Egger method (P=.07) did not support this causal relationship, yet its directionality was consistent with the other three methods. None of the four analysis methods supported a reverse causal relationship between AS and urolithiasis. CONCLUSION Our study demonstrates a causal relationship between AS and urolithiasis, with no evidence of reverse causality. Given the increased risk of urolithiasis in AS patients, it is crucial to implement preventive strategies and early detection. Stone composition analysis should also be incorporated into clinical practice for these patients, as it can provide essential insights into the metabolic and genetic factors contributing to stone formation, thus improving diagnostic accuracy and treatment outcomes. Future studies are needed to further validate these findings and explore the detailed mechanisms involved.
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Affiliation(s)
- Fei Yan
- Department of Acupuncture and Moxibustion, Chongqing Jiangbei Hospital of Traditional Chinese Medicine, China
| | - Jie Liu
- Pain Management Department, Zhongxian County Traditional Chinese Medicine Hospital, Chongqing, China
| | - Jing Tao
- Pain Management Department, Zhongxian County Traditional Chinese Medicine Hospital, Chongqing, China
| | - Lingfeng Wu
- Department of Acupuncture and Moxibustion, Chongqing Jiangbei Hospital of Traditional Chinese Medicine, China
| | - Jingping Yang
- Department of Acupuncture and Moxibustion, Chongqing Jiangbei Hospital of Traditional Chinese Medicine, China
| | - Suqing Jing
- Department of Acupuncture and Moxibustion, Chongqing Jiangbei Hospital of Traditional Chinese Medicine, China.
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Zhang F, Li W. The complex relationship between vitamin D and kidney stones: balance, risks, and prevention strategies. Front Nutr 2024; 11:1435403. [PMID: 39346653 PMCID: PMC11427370 DOI: 10.3389/fnut.2024.1435403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 09/04/2024] [Indexed: 10/01/2024] Open
Abstract
The association between vitamin D and kidney stones is characterized by a remarkable multi-dimensional complexity involving numerous physiological and metabolic pathways. Vitamin D is pivotal in maintaining calcium-phosphorus metabolic homeostasis and bone health. However, fluctuations in its intake, whether excessive or insufficient, May potentially increase the risk of kidney stones. Vitamin D exerts its influence on kidney stone formation indirectly by increasing the efficiency of intestinal calcium absorption and regulating renal calcium excretion. Moreover, there is a robust correlation between various states of vitamin D, particularly its active form, 1,25-dihydroxyvitamin D, and the development of numerous kidney stones. This finding underscores the necessity of individualized medical treatment in vitamin D supplementation and kidney stone prevention. When developing treatment strategies, it is essential to consider the patient's genetic background, lifestyle, environmental factors, and overall health. To prevent the formation of kidney stones, it is recommended that patients adopt a comprehensive approach, which May include measures such as moderate sun exposure, dietary modification, moderate exercise, and weight management. These preventive measures are designed to maintain healthy calcium and phosphorus metabolism and reduce kidney stone formation risk. Future studies should aim to elucidate the detailed mechanisms of vitamin D metabolism, individual differences, and the role of genes in this process. Furthermore, the role of lifestyle interventions in preventing kidney stones requires greater attention. Moreover, the implementation of large-scale, long-term prospective studies and randomized controlled trials will facilitate the assessment of the actual effects of diverse vitamin D supplementation strategies, thereby providing a robust scientific foundation for advancing more precise prevention strategies and clinical guidelines.
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Affiliation(s)
- Fan Zhang
- Department of Endocrinology, Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
- Department of Clinical Nutrition, Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Wenjian Li
- Department of Urology, Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
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Akinci A, Karaburun MC, Kubilay E, Solak VT, Sanci A, Soygur T, Burgu B. Urinary stone in infants; should vitamin D prophylaxis be stopped? J Pediatr Urol 2024; 20:604.e1-604.e6. [PMID: 38702222 DOI: 10.1016/j.jpurol.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND This study investigated the effect of the discontinuation of vitamin D supplementation on kidney stone formation in children under 2 years of age. METHODS This study involved a retrospective analysis of two patient groups. The first group comprised postoperative patients who were stone-free, while the second group consisted of asymptomatic patients with kidney stones. The patients who discontinued vitamin D supplementation and those who continued were compared in terms of stone formation and stone size progression. The data collected included patient characteristics, stone size measurements, and laboratory results. RESULTS The findings showed that the discontinuation of vitamin D supplementation was not associated with kidney stone formation or the progression of stone size in either group. For patients who were stone-free on ultrasonography 1 month after the operation, according to the 12-month ultrasonography evaluation, in the group that discontinued vitamin D, 42 (78%) patients had no stones, 6 (11%) patients had stones larger than 3 mm, and 6 (11%) patients had microlithiasis. However, in the group that continued vitamin D, 49 (72%) patients were stone-free, 10 (15%) patients had stones larger than 3 mm, and 9 (13%) patients had microlithiasis. There was no difference between the groups in terms of stone status at 12 months (p = 0.76). For patients with asymptomatic kidney stones, the initial stone sizes were similar between the groups (p = 0.74). During the 6th month of ultrasound, the changes in stone size were 1.76 ± 1.81 mm and 1.79 ± 1.75 mm for the two groups, respectively (p = 0.9). During the 12-month ultrasound measurement, the changes in stone size were 1.98 ± 2.93 mm and 2.60 ± 2.48 mm for the two groups, respectively (p = 0.09). CONCLUSIONS We believe that more research is needed to make definitive recommendations regarding vitamin D prophylaxis in infants with kidney stones. Although the first objective of our study is not conclusively proven with the current findings, we recommend continued vitamin D prophylaxis in infants with urolithiasis.
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Affiliation(s)
- Aykut Akinci
- Department of Pediatric Urology, Denizli State Hospital, Denizli, Turkey.
| | | | - Eralp Kubilay
- Department of Urology, International Cyprus University, Cyprus
| | | | - Adem Sanci
- Department of Urology, Etlik City Hospital, Ankara, Turkey
| | - Tarkan Soygur
- Department of Pediatric Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Berk Burgu
- Department of Pediatric Urology, Ankara University School of Medicine, Ankara, Turkey
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Xie Z, Zhuang Y, Peng S, Zhou X, Zhang G, Jiang H, Zhang C, Chen N. Association between milk consumption and kidney stones in U.S. adults: results from NHANES 2007-2018. Front Nutr 2024; 11:1394618. [PMID: 38812937 PMCID: PMC11133716 DOI: 10.3389/fnut.2024.1394618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/06/2024] [Indexed: 05/31/2024] Open
Abstract
Background Dietary strategies play a crucial role in the prevention of kidney stones. While milk is known for its rich nutritional content, its impact on kidney stone formation remains unclear. This study aimed to examine the relationship between milk consumption and the risk of kidney stones among U.S. adults. Methods We included 24,620 participants aged 20 and older from the National Health and Nutrition Examination Survey (2007-2018). Milk consumption was defined based on each participant's response to the questionnaire item on "Past 30 day milk product consumption." Kidney stones history was self-reported by participants. The analysis employed weighted multivariate logistic regression models, followed by subgroup analyses for result validation, and explored the age-related dynamics of milk consumption's effect on kidney stone risk using a restricted cubic spline model. Results Adjusted findings revealed that higher milk intake was associated with a decreased risk of kidney stones (odds ratio [OR] = 0.90, 95% confidence interval [CI] 0.85-0.96), notably among women (OR = 0.86, 95% CI 0.80-0.92) but not significantly in men (OR = 0.94, 95% CI 0.86-1.02). Smoothed curves across all ages showed that women consuming milk had a lower incidence of kidney stones than those who did not, particularly with regular consumption. Conclusion This study uncovered that across all age groups, higher frequency of milk consumption in women is associated with a reduced risk of kidney stones. However, further prospective cohort studies are needed to confirm this finding.
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Affiliation(s)
- Zhouzhou Xie
- Meizhou Clinical Institute of Shantou University Medical College, Meizhou, China
- Department of Urology, Meizhou People's Hospital (Meizhou Academy of Medical Sciences), Meizhou, China
| | - Yiming Zhuang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shansen Peng
- Meizhou Clinical Institute of Shantou University Medical College, Meizhou, China
- Department of Urology, Meizhou People's Hospital (Meizhou Academy of Medical Sciences), Meizhou, China
| | - Xiaoqi Zhou
- Meizhou Clinical Institute of Shantou University Medical College, Meizhou, China
- Department of Urology, Meizhou People's Hospital (Meizhou Academy of Medical Sciences), Meizhou, China
| | - Guihao Zhang
- Meizhou Clinical Institute of Shantou University Medical College, Meizhou, China
- Department of Urology, Meizhou People's Hospital (Meizhou Academy of Medical Sciences), Meizhou, China
| | - Huiming Jiang
- Meizhou Clinical Institute of Shantou University Medical College, Meizhou, China
- Department of Urology, Meizhou People's Hospital (Meizhou Academy of Medical Sciences), Meizhou, China
| | - Changyi Zhang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Nanhui Chen
- Meizhou Clinical Institute of Shantou University Medical College, Meizhou, China
- Department of Urology, Meizhou People's Hospital (Meizhou Academy of Medical Sciences), Meizhou, China
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Zeng H, Liu Z, He Y, Chen H, He J, Liu M, Wu S, He H, Huang C, Xu R. Multivitamins co-intake can reduce the prevalence of kidney stones: a large-scale cross-sectional study. Int Urol Nephrol 2024:10.1007/s11255-024-04021-9. [PMID: 38564076 DOI: 10.1007/s11255-024-04021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND This research aimed to explore the association between changes in the intake of common individual vitamins and combinations of vitamins and the prevalence of kidney calculi. METHODS We used data from NHANES to investigate the association between nine common vitamins and kidney stone prevalence. Participants were clustered into several vitamin exposure patterns using an unsupervised K-means clustering method. We used logistic regression models and restrictive cubic spline curves to explore the influence of vitamins. RESULTS The regression model exposed that compared to lower intake, high intake of vitamin B6 [Q4: OR (95% CI) = 0.76 (0.62, 0.93)], vitamin C [Q4: OR (95% CI) = 0.73 (0.59, 0.90)] and vitamin D [Q4: OR (95% CI) = 0.77 (0.64, 0.94)] individually exerted protective effects against the prevalence of kidney stones. Furthermore, the restrictive cubic spline analysis showed that the protective effect against the prevalence of kidney stones is enhanced as the take of vitamin B6 and vitamin D increased. Moreover, with the increase in vitamin C intake, its protective effect may turn into a risk factor. Regarding mixed exposure, Cluster 4 exhibited a significant protective effect against kidney stones compared with Cluster 1 [Model 3: OR (95% CI) = 0.79 (0.64, 0.98)]. CONCLUSIONS Our research revealed that high levels of vitamin B6 and vitamin D intake were linked to a lower prevalence of kidney stone. With the gradual increase intake of vitamin C, the prevalence of kidney calculi decreased first and then increased. In addition, the co-exposure of nine vitamins is a protective factor for kidney stone disease.
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Affiliation(s)
- Hongbo Zeng
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziyi Liu
- Department of Emergency Medicine, The Second Xiangya Hospital of Central-South University, Emergency and Difficult Diseases Institute of Central South University, Changsha, China
| | - Yunhui He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huixiang Chen
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mingke Liu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shuiqing Wu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haiqing He
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Changkun Huang
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China.
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Béland K, Rousseau C, Lair S. Diet-induced nephrocalcinosis in aquarium-raised juvenile spotted wolffish Anarhichas minor. DISEASES OF AQUATIC ORGANISMS 2024; 157:19-30. [PMID: 38236079 DOI: 10.3354/dao03769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Wolffish are regularly housed in aquaria, but little data on their husbandry and health is available for caretakers. High occurrence rates of nephrocalcinosis and urolithiasis have been observed in Atlantic Anarhichas lupus and spotted A. minor wolffish housed at 2 Canadian zoological institutions. To explore the effect of diet on nephrocalcinosis and urolithiasis development, a 16 mo prospective study was conducted. A total of 32 juvenile spotted wolffish were randomly assigned to one of 4 experimental groups fed exclusively with the following diet: (1) Skretting® Europa 18 pellets; (2) Mazuri® LS Aquatic Carni-Blend Diet Formula; (3) vitamin-supplemented fish-based diet, and (4) vitamin-supplemented invertebrate-based diet. Urinalysis, radiographs, and complete necropsies were performed at the end of the study. None of the wolffish developed uroliths during the study period. All specimens fed with the fish-based and invertebrate-based diets developed nephrocalcinosis, whereas this condition was seen in 12.5 and 0% of the fish in the Skretting® and Mazuri® groups, respectively. Affected wolffish often presented with oxalate crystalluria and increased radiodensity of the posterior kidneys. Urinalysis and radiographic study were considered useful in the antemortem diagnosis of nephrocalcinosis. None of the previously published risk factors for the development of nephrocalcinosis in fish were supported by the results of this study. However, nutritional analyses of the 4 diets suggest that high dietary levels of gelatin or vitamin C or low levels of vitamin E could be potential risk factors for the development of nephrocalcinosis in spotted wolffish and thus warrant further study.
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Affiliation(s)
- Karine Béland
- Centre québécois sur la santé des animaux sauvages/Canadian Wildlife Health Cooperative, Faculté de médecine vétérinaire, Université de Montréal, St. Hyacinthe, Quebec J2S 2M2, Canada
| | | | - Stéphane Lair
- Centre québécois sur la santé des animaux sauvages/Canadian Wildlife Health Cooperative, Faculté de médecine vétérinaire, Université de Montréal, St. Hyacinthe, Quebec J2S 2M2, Canada
- Sépaq, Aquarium du Québec, Quebec City, Quebec G1W 4S3, Canada
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Singh RP, Mishra A, Chandel SS, Agarwal M, Chawra HS, Singh M, Dubey G. Unlocking New Approaches to Urolithiasis Management Via Nutraceuticals. Curr Pharm Biotechnol 2024; 25:1124-1131. [PMID: 37608670 DOI: 10.2174/1389201024666230821122416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 08/24/2023]
Abstract
Urolithiasis, commonly known as kidney stones, is characterized by the formation of hard deposits in the urinary tract. These stones can cause severe pain and discomfort, and their management typically involves a combination of medical interventions and lifestyle modifications. According to the literature, 30% and 50% of urolithiasis cases recur. Between 9 and 12% of persons in industrialised countries are predicted to have urolithiasis at some time. Due to the high frequency of stone formation, recurrent nature, and prevalence in adults, it has a significant impact on society, the person, and the health care system. Adopting the best prophylactic measures is crucial in light of these developments to decrease the impact of urolithiasis on individuals and society. In recent years, there has been growing interest in the potential role of nutraceuticals in the management of urolithiasis. Nutraceuticals, such as herbal extracts, vitamins, minerals, and probiotics, have gained recognition for their potential in promoting urinary health and reducing the risk of urolithiasis. These compounds can aid in various ways, including inhibiting crystal formation, enhancing urine pH balance, reducing urinary calcium excretion, and supporting kidney function. Additionally, nutraceuticals can help alleviate symptoms associated with urolithiasis, such as pain and inflammation. While medical interventions remain crucial, incorporating nutraceuticals into a comprehensive management plan can offer a holistic approach to urolithiasis, improving patient outcomes and quality of life. Therefore, nutraceuticals may be a desirable choice for treating and avoiding recurring urolithiasis for patients and medical professionals. Therefore, the present study has focused on nutraceuticals' role in preventing urolithiasis.
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Affiliation(s)
- Ravindra Pal Singh
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Anurag Mishra
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | | | - Mohit Agarwal
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Himmat Singh Chawra
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Mithilesh Singh
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Gaurav Dubey
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
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