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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ECalcium and vitamin D supplementation together with calcium hyperabsorption appear to be related to episodes of hypercalcemia and hypercalciuria. Women with 24-hour urine calcium values\u2005\u0026gt;\u2005132 mg have a higher risk for developing hypercalciuria\u2005\u0026gt;\u2005300 mg. Women with hypercalciuria are at increased risk for kidney stones.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ecalcium\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Evitamin D\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Esupplement\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehypercalcemia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehypercalciuria\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ekidney stones\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecalcium hyperabsorption\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eendocrinology, diabetes \u0026amp; metabolism clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EApproximately 50% of women in the United States take calcium and vitamin D supplements [Centers for Disease Control and Prevention. \u003Ca href=\u0022http:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db61.pdf\u0022\u003Ehttp:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db61.pdf\u003C\/a\u003E. Accessed March 12, 2015]. From 1988 to 2002, vitamin D use increased from 50% to 56%, and from 1988 to 2006, calcium use increased from 28% to 61% in women aged\u2005\u0026gt;\u200560 years. Around this same time, the prevalence of kidney stones in the United States has increased from about 1 in 20 persons to 1 in 11 persons [Scales CD et al. \u003Cem\u003EEur Urol.\u003C\/em\u003E 2012]. Additionally, the Women\u2019s Health Initiative study found an increased risk of kidney stones with the use of vitamin D 400 IU\/d plus calcium 2100 mg\/d [Jackson RD et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E. 2006].\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EUntil now there have been no studies on the effect of different doses of vitamin D and calcium supplementation on hypercalcemia and hypercalciuria. Two double-blinded randomized trials by Vinod Yalamanchili, MD, Creighton University School of Medicine, Omaha, Nebraska, USA, and his group assessed the effect of vitamin D and calcium supplementation on serum 25-hydroxyvitamin D and serum and urine calcium levels in older (age range, 57\u201390 years) and young (age range, 25\u201345 years) women with vitamin D insufficiency. A total of 163 white and 110 black older women were randomized to vitamin D\u003Csub\u003E3\u003C\/sub\u003E 400, 800, 1600, 2400, 3200, 4000, or 4800 IU\/d or placebo. The young women (113 white, 79 black) were randomized to vitamin D\u003Csub\u003E3\u003C\/sub\u003E 400, 800, 1600, or 2400 IU\/d or placebo. All groups received calcium supplementation. Calcium intake was estimated from 7-day diaries. The average daily calcium supplementation was 580 mg in the elderly women and 450 mg in the young women.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EHypercalcemia occurred in 11% of the elderly white women, 2.5% of the elderly black women, and 1% of the young white and black women. Hypercalciuria was present in 36% of the elderly white women, 25% of elderly black women, 27% of young white women, and 21% of young black women. There was no dose-response relationship between hypercalcemia or hypercalciuria and the vitamin D dose.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EReceiver operating characteristic curves (specificity 90%) showed that women with a baseline 24-hour urine calcium\u2005\u0026gt;\u2005132 mg were more likely to develop hypercalciuria\u2005\u0026gt;\u2005300 mg. Women with a baseline 24-hour urine calcium\u2005\u0026gt;\u2005180 mg had a 20-fold increased risk of developing hypercalciuria\u2005\u0026gt;\u2005300 mg. Baseline urine calcium was \u0026lt;\u2005300 mg in 66%, 300 to 400 mg in 20%, and \u0026gt;\u2005400 mg in 13% of the women.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EWomen with hypercalciuria\u2005\u0026gt;\u2005400 mg (n\u2005=\u200519) or 300 to 400 mg (n\u2005=\u200528) had a significantly higher mean 24-hour calcium (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.0001), baseline 1,25-dihydroxyvitamin D (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.008), and higher baseline calcium absorption (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.032) compared with women with hypercalciuria \u0026lt;\u2005300 mg or 300 to 400 mg. Further, women with hypercalciuria \u0026gt;\u2005400 mg were also significantly younger (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.0005) than those with hypercalciuria\u2005\u0026lt;\u2005300 mg or 300 to 400 mg.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EThis study showed that hypercalcemia and hypercalciuria are not associated with the vitamin D dose, but more likely related to calcium supplementation and calcium hyperabsorption. Based on the study results and the number of women taking calcium and vitamin D supplements, the investigators estimated that approximately 15 million women on supplements have periodic hypercalcemia and may be at increased risk for kidney stones. Women with hyperabsorption (24-hour urine calcium\u2005\u0026gt;\u2005132 mg) do not need calcium or vitamin D supplementation.Summary\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/4\/18.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzln31\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}