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...
| Publicado en: | American Journal of Clinical Nutrition Vol. 104; no. 4; pp. 1039 - 1052 |
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| Autores principales: | , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
10/1/2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118665988&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118665988 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00029165 AJC jtl: American Journal of Clinical Nutrition issn: 00029165 maglogo: N pubinfo: dt: 10/1/2016 vid: 104 iid: 4 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 118665988 118665988 118665988 10.3945/ajcn.116.134981 118665988 ppf: 1039 ppct: 13 formats: tig: 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 refInfo: holdings: @attributes: islocal: N |
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