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Prevalence and metabolic abnormalities of vitamin D-inadequate patients presenting with urolithiasis to a tertiary stone clinic.
[cystinuria]
To
assess
the
prevalence
and
metabolic
abnormalities
of
patients
with
inadequate
vitamin
D
(
VD
)
presenting
with
urolithiasis
to
a
tertiary
stone
clinic
in
North
America
.
A
retrospective
review
of
consecutive
patients
presenting
from
August
2009
to
January
2010
was
performed
.
Demographic
and
clinical
data
were
collected
together
with
metabolic
stone
workup
,
including
2
24
-
hour
urine
collections
and
serum
25
-
hydroxy
VD
[
25
(
OH
)
D
]
.
VD
inadequacy
(
VDI
)
included
VD
deficiency
and
VD
insufficiency
defined
as
25
-
(
OH
)
VD
levels
<
20
ng
/
mL
and
21
-
29
ng
/
mL
,
respectively
.
Of
101
patients
,
81
(
80
.
2
%
)
were
found
to
have
VDI
:
34
(
33
.
7
%
)
were
deficient
and
47
(
46
.
5
%
)
had
insufficient
VD
.
Mean
age
was
50
.
4
±
15
.
8
years
and
the
mean
body
mass
index
was
28
.
7
±
5
.
8
kg
/
m
(
2
)
.
Forty
-
two
percent
were
smokers
,
51
%
were
recurrent
stone
formers
,
and
54
%
had
positive
family
history
of
urolithiasis
.
Hyperparathyroidism
was
detected
in
25
.
9
%
of
patients
,
of
which
91
%
of
them
were
secondary
to
VDI
.
Hypocalcemia
and
hyperuricemia
were
found
in
36
%
and
11
%
of
patients
,
respectively
.
Of
81
VDI
patients
,
69
(
85
.
2
%
)
had
complete
24
-
hour
urine
collections
,
of
which
92
.
7
%
had
at
least
one
abnormality
.
However
,
only
40
%
of
patients
with
normal
VD
had
metabolic
abnormalities
(
P
<
.
0001
)
.
The
most
prevalent
pattern
of
urinary
abnormalities
in
VDI
patients
were
suboptimal
volume
(
45
%
)
,
hypocitaturia
(
24
%
)
,
hypocalciuria
(
33
%
)
,
hypercalciuria
(
20
%
)
,
hyperuricosuria
(
16
%
)
,
cystinuria
(
5
%
)
,
and
hyperoxaluria
(
7
.
2
%
)
.
In
this
preliminary
study
,
patients
presenting
with
urolithiasis
were
found
to
have
a
high
prevalence
of
inadequate
VD
associated
with
abnormalities
on
metabolic
stone
work-up
.
Diseases
Validation
Diseases presenting
"abnormalities on metabolic stone work-up"
symptom
cystinuria
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