Vitamin D₃ Variation between Children and Adults with Reference to Renal Stones, Environment and Urinary Tract Infections

Abstract

Purpose: A better understanding of urinary tract infection (UTI) and the role of host, bacterial and environmental factors have improved the ability to identify the patients at risk and prevent or minimize sequelae. Kidney stones may be a complicated subject and its etiology is related to diet, increase urinary solutes and colloids in hot weather. Hypercalcaemia produced by taking large doses of vitamin D, creates high blood pressure and calcium deposits that can produce renal and bludder stones in all age groups including children. The objective of the present study was to estimate the serum level of vitamin D among patients particularly children taking treatable vitamin D. Correlation between vitamin D renal stones and UTI was also assessed. Methods: The number of patients studied was 150 collected during 2010 and 2011 in University teaching hospital. Forty two of them were children. The patients under study should have renal stone confirmed by ultrasound examination. Urine, blood and stone samples were taken for relevant laboratory investigations including identification of bacteriuria and its causative agents. Serum ions and vitamin D were also estimated. Type of renal stone collected was chemically identified. Results: One hundred and fifty patients with urolithiasis were included in the present study whose ages ranged from 8 months to 69 years and the ratio of males to females was 1.7:1. The frequency of patients revealed UTI was 52% and 78% of the infected patients were suffered from Gram-negative bacteria particularly Escherichia coli . Renal stones of mixed chemical composition were almost 72% and 78.2% of the stones were infection type. The mean of serum calcium was 2.157 mmol/L. The serum means of vitamin D among children and adults were 50.9 and 31.4 nmol/L respectively and the peak of this vitamin was recorded during summer. Conclusion: The frequency of UTI among urolithiasis patients was greater than that of non-urolithiasis. Enterobacteriaceae was the dominant family causing UTI particularly among females. Urolithiasis was more prevalent in males (62%). Recurrence of urolithiasis was high (39%) which indicated insufficient treatment of the underlying causes. Serum ions concentrations among children and adults were variables. Vitamin D values in children were higher than those estimated among adults and the peak of its overall concentration mean was found during summer (39.7 nmol/L). There was a strong relation between vitamin D level and the incidence of urolithiasis particularly among children with dietary problems.