Vitamin D, Hypercalciuria and Kidney Stones (Letavernier E and Daudon M)
The findings of a broad literature search of two French researchers on the relationship between vitamin D, hypercalciuria and kidney stones were published as a review in Nutrients.
Recently there has been huge increase in vitamin D prescription in the general population due to the fact that low 25-hydroxyvitamin D serum levels have been associated with a broad spectrum of diseases. NIH-PubMed/Medline, ISI-Web of Science and Cochrane Library were searched to identify relevant studies. Researchers have observed an increased frequency of kidney stone episodes in prospective studies evaluating vitamin D alone or in association with calcium supplements. Also epidemiological studies have identified an association between high 25-hydroxyvitamin D serum levels and kidney stone formation in some groups of patients. Moreover, urinary calcium excretion has been shown to increase in response to vitamin D supplements, at least in some groups of kidney stone formers.
It seems likely that some predisposed individuals, possibly prone to transforming 25-hydroxyvitamin D into calcitriol, with a reduced capacity for degrading calcitriol, or those who are more “sensitive” to vitamin D signaling, are more at risk of developing hypercalciuria and kidney stones in response to vitamin D supplements. However, the predisposing alleles have not been identified yet. A question has been raised concerning the potential role of vitamin D prescribed during infancy, since Randall’s plaques that precede the development of kidney stones are more frequently observed in children nowadays, which may in turn lead to the formation of stones years or decades later.
The authors concluded: “The identification of patients at risk of developing kidney stones in response to vitamin D prescription will be a medical challenge in the future.”
Dr. Katarzyna Maresz, president of the International Science and Health Foundation, points out the fact that it has already been shown by Wei et al (2017) in a Mendelian randomization study previously conducted in a Flemish population that the risk of nephrolithiasis (kidney stones) increases with vitamin K shortage, as exemplified by higher plasma levels of desphospho-uncarboxylated MGP (dp-ucMGP). “These findings suggest that increasing the dietary intake of vitamin K2 decreases the risk of kidney stones, so it should be recommended to use K2 with D3 too,” she emphasizes.
References:
- Letavernier E and Daudon M (2018) Vitamin D, Hypercalciuria and Kidney Stones. Nutrients 10(3): 366. doi: 10.3390/nu10030366
- Wei et al. (2017) The risk of nephrolithiasis is causally related to inactive matrix Gla protein, a marker of vitamin K status: a Mendelian randomization study in a Flemish population. Nephrol Dial Transplant 1–9.