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

Background: Vitamin D supplementation is increasingly being used in higher doses in randomized controlled trials (RCTs). However, adverse events from very large annual doses of vitamin D have been shown in 2 RCTs, whereas in a third RCT, low-dose vitamin D, with calcium supplements, was shown to inc...

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Publicado en:American Journal of Clinical Nutrition Vol. 104; no. 4; pp. 1039 - 1052
Autores principales: Malihi, Zarintaj, Zhenqiang Wu, Stewart, Alistair W., Lawes, Carlene M. M., Scragg, Robert
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Elsevier B.V. 10/1/2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 10/1/2016
      vid: 104
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      pub: Elsevier B.V.
      place: New York, New York
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        10.3945/ajcn.116.134981
        118665988
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        atl: Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis.
      aug:
        au:
          Malihi, Zarintaj
          Zhenqiang Wu
          Stewart, Alistair W.
          Lawes, Carlene M. M.
          Scragg, Robert
        affil: School of Population Health, University of Auckland, Auckland, New Zealand
      sug:
        subj:
          Vitamin D Adverse Effects
          Kidney Calculi Chemically Induced
          Dietary Supplementation
          Hypercalcemia Chemically Induced
          Hypercalciuria Chemically Induced
          Calcium Metabolism
          Professional Practice, Evidence-Based
          PubMed
          Embase
          Cochrane Library
          Systematic Review
          Meta Analysis
          Randomized Controlled Trials
          Data Analysis Software
          Confidence Intervals
          P-Value
          Relative Risk
          Human
          Funding Source
      ab: Background: Vitamin D supplementation is increasingly being used in higher doses in randomized controlled trials (RCTs). However, adverse events from very large annual doses of vitamin D have been shown in 2 RCTs, whereas in a third RCT, low-dose vitamin D, with calcium supplements, was shown to increase kidney stone risk. Objective: We analyzed the side effects related to calcium metabolism in RCTs, specifically hypercalcemia, hypercalciuria, and kidney stones, in participants who were given vitamin D supplements for ≥24 wk compared with in subjects in the placebo arm. Design: The following 3 main online databases were searched: Ovid Medline (PubMed), EMBASE, and the Cochrane Library. Software was used for the meta-analysis. Results: A total of 48 studies with 19,833 participants were identified, which reported ≥1 of the following side effects: hypercalcemia, hypercalciuria, or kidney stones. Of these studies, kidney stones were reported in only 9 trials with a tendency for fewer subjects reporting stones in the vitamin D arm than in the placebo arm (RR: 0.66, 95% CI: 0.41, 1.09; P = 0.10). In 37 studies, hypercalcemia was shown with increased risk shown for the vitamin D group (RR: 1.54; 95% CI: 1.09, 2.18; P = 0.01). Similar increased risk of hypercalciuria was shown in 14 studies for the vitamin D group (RR: 1.64; 95% CI: 1.06, 2.53; P = 0.03). In subgroup analyses, it was shown that the effect of vitamin D supplementation on risk of hypercalcemia, hypercalciuria, or kidney stones was not modified by baseline 25-hydroxyvitamin D, vitamin D dose and duration, or calcium co-supplementation. Conclusions: Long-term vitamin D supplementation resulted in increased risks of hypercalcemia and hypercalciuria, which were not dose related. However, vitamin D supplementation did not increase risk of kidney stones. Additional large RCTs of long-term vitamin D supplementation are required to confirm these findings.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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