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Vitamin D and Calcium Homeostasis in Infants with Urolithiasis

  • Agnieszka SzmigielskaEmail author
  • Małgorzata Pańczyk-Tomaszewska
  • Małgorzata Borowiec
  • Urszula Demkow
  • Grażyna Krzemień
Chapter
Part of the Advances in Experimental Medicine and Biology book series

Abstract

The incidence of urolithiasis in infants is unknown. The aim of this study was to investigate clinical characteristics, nutrition, calcium, phosphate, 25-hydroxyvitamin D (25(OH)D), alkaline phosphate, and parathyroid hormone in infants with urolithiasis. There were 32 infants (23 boys and 9 girls) of the mean age of 6.4 ± 3.7 months (range 2–12 months), with diagnosis of urolithiasis enrolled into the study. Boys were younger than girls (5.3 vs. 9.1 months, respectively; p < 0.05). The infants were receiving prophylactic vitamin D3. Twenty-one of them were fed with milk formula, 9 were breastfed, and 2 were on a mixed diet. The major clinical symptoms consisted of irritability in 19 (59%) and urinary tract infection in 6 (19%) infants. Hypercalcemia and hyperphosphatemia were detected in the serum in 30 (94%) and 19 (60%) infants, respectively. The serum calcium level was higher in boys than girls (10.8 vs. 9.8 mg/dL, respectively; p < 0.05). Four (12.5%) infants had increased activity of alkaline phosphatase. The serum level of 25(OH)D was high in 3 (9%), low in 2 (6%), and normal in 27 (85%) infants. Parathyroid hormone was low in eight (25%) infants. Hypercalciuria and hyperphosphaturia were found in 11 (34%) boys and 8 (25%) girls. Family history of urolithiasis was positive in eight (25%) infants. We conclude that urolithiasis occurs in infancy more often in boys fed with milk formula and in those who received vitamin D supplementation. Hypercalcemia, hyperphosphatemia, and hypercalciuria are the most common changes present in clinical metabolic tests.

Keywords

Calcium homeostasis Hypercalcemia Hypercalciuria Hyperphosphaturia Infants Urolithiasis Vitamin D3 

Notes

Conflicts of Interest

The authors declare that they have no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all parents/guardians of all the individual participants included in the study.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Agnieszka Szmigielska
    • 1
    Email author
  • Małgorzata Pańczyk-Tomaszewska
    • 1
  • Małgorzata Borowiec
    • 2
  • Urszula Demkow
    • 3
  • Grażyna Krzemień
    • 1
  1. 1.Department of Pediatrics and NephrologyWarsaw Medical UniversityWarsawPoland
  2. 2.Student Scientific Group at the Department of Pediatrics and NephrologyWarsaw Medical UniversityWarsawPoland
  3. 3.Department of Laboratory Diagnostics and Clinical Immunology of Developmental AgeWarsaw Medical UniversityWarsawPoland

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