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Calcium and vitamin D have a synergistic role in a rat model of kidney stone disease.

Abstract
Vitamin D supplementation in humans should be accompanied by calcium administration to avoid bone demineralization through vitamin D receptor signaling. Here we analyzed whether long-term exposure of rats to vitamin D supplementation, with or without a calcium-rich diet, would promote kidney stone formation. Four groups of rats received vitamin D alone (100,000 UI/kg/3 weeks), a calcium-enriched diet alone, both vitamin D supplementation and calcium-enriched diet, or a standard diet (controls) for 6 months. Serum and urine parameters and crystalluria were monitored. Kidney stones were assessed by 3-dimensional micro-computed tomography, infrared spectroscopy, von Kossa/Yasue staining, and field emission scanning electron microscopy. Although serum calcium levels were similar in the 4 groups, rats receiving vitamin D had a progressive increase in urinary calcium excretion over time, especially those receiving both calcium and vitamin D. However, oral calcium supplementation alone did not increase urinary calcium excretion. At 6 months, rats exposed to both calcium and vitamin D, but not rats exposed to calcium or vitamin D alone, developed significant apatite kidney calcifications (mean volume, 0.121 mm(3)). Thus, coadministration of vitamin D and increased calcium intake had a synergistic role in tubular calcifications or kidney stone formation in this rat model. Hence, one should be cautious about the cumulative risk of kidney stone formation in humans when exposed to both vitamin D supplementation and high calcium intake.
AuthorsEmmanuel Letavernier, Cécile Verrier, Florent Goussard, Joëlle Perez, Léa Huguet, Jean-Philippe Haymann, Laurent Baud, Dominique Bazin, Michel Daudon
JournalKidney international (Kidney Int) Vol. 90 Issue 4 Pg. 809-17 (10 2016) ISSN: 1523-1755 [Electronic] United States
PMID27475231 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Apatites
  • Calcium, Dietary
  • Receptors, Calcitriol
  • Vitamin D
Topics
  • Animals
  • Apatites (metabolism)
  • Bone Demineralization, Pathologic (etiology)
  • Calcium, Dietary (blood, pharmacology, urine)
  • Dietary Supplements (adverse effects)
  • Disease Models, Animal
  • Drug Synergism
  • Kidney Calculi (blood, chemistry, etiology, urine)
  • Male
  • Microscopy, Electron, Scanning
  • Rats
  • Rats, Sprague-Dawley
  • Receptors, Calcitriol (metabolism)
  • Renal Elimination
  • Spectroscopy, Fourier Transform Infrared
  • Vitamin D (pharmacology)
  • X-Ray Microtomography

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