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Vitamin D and Calcium Homeostasis in Infants with Urolithiasis

Agnieszka Szmigielska1, Małgorzata Pańczyk-Tomaszewska2, Małgorzata Borowiec3

  • 1Department of Pediatrics and Nephrology, Warsaw Medical University, Warsaw, Poland. aszmigielska@wum.edu.pl.

Advances in Experimental Medicine and Biology
|January 12, 2019
PubMed

Insights

Infant urolithiasis is more common in boys, often linked to milk formula and vitamin D supplements. Key findings include hypercalcemia, hyperphosphatemia, and hypercalciuria in affected infants.

Area of Science:

  • Pediatric Nephrology
  • Infant Health
  • Urolithiasis Research

Background:

  • The incidence of urolithiasis (kidney stones) in infants remains largely unknown.
  • Infantile urolithiasis presents unique diagnostic and management challenges.
  • Understanding risk factors and metabolic profiles is crucial for early intervention.

Purpose of the Study:

  • To investigate the clinical characteristics of urolithiasis in infants.
  • To analyze nutritional factors, including milk formula and vitamin D supplementation.
  • To assess serum and urinary levels of calcium, phosphate, 25-hydroxyvitamin D (25(OH)D), alkaline phosphatase, and parathyroid hormone.

Main Methods:

  • Retrospective analysis of 32 infants diagnosed with urolithiasis (2-12 months old).
  • Evaluation of clinical symptoms, feeding history (breastfed, formula-fed, mixed), and family history.
  • Biochemical analysis of serum and urine for calcium, phosphate, 25(OH)D, alkaline phosphatase, and parathyroid hormone levels.

Main Results:

  • Urolithiasis was more prevalent in boys (23 vs. 9 girls), who were also younger at diagnosis.
  • Common symptoms included irritability (59%) and urinary tract infections (19%).
  • Elevated serum calcium (94%) and phosphate (60%) were frequent. Hypercalciuria and hyperphosphaturia were observed in 34% and 25% of infants, respectively. Vitamin D supplementation and milk formula feeding were common.

Conclusions:

  • Infantile urolithiasis appears more common in boys, particularly those fed milk formula with vitamin D supplementation.
  • Metabolic abnormalities such as hypercalcemia, hyperphosphatemia, and hypercalciuria are prevalent in this population.
  • Further research is needed to elucidate the precise mechanisms and long-term implications of urolithiasis in infancy.

Keywords:
Calcium homeostasisHypercalcemiaHypercalciuriaHyperphosphaturiaInfantsUrolithiasisVitamin D3

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