Urinary tract stone occurrence in the Women's Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements.
Am J Clin Nutr. 2011 Jul;94(1):270-7. Epub 2011 Apr 27.
Wallace RB, Wactawski-Wende J, O'Sullivan MJ, Larson JC, Cochrane B, Gass M, Masaki K.
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA. robert-wallace at uiowa.edu
The Women's Health Initiative (WHI) randomized clinical trial (RCT) of calcium plus vitamin D (CaD) supplements found a 17% excess in urinary tract stone incidence in the supplemented group. This study evaluated whether this risk is modified by participant characteristics.
We examined the correlates of urinary tract stone occurrence in the CaD arm of the WHI trial.
We analyzed an RCT involving 36,282 postmenopausal women aged 50-79 y from 40 WHI centers: 18,176 women received 500 mg calcium carbonate plus 200 IU vitamin D(3) twice daily (1000 mg and 400 IU daily, respectively), and 18,106 women received a matching placebo for an average of 7.0 y. The incidence of urinary tract stones was determined.
The incidence of self-reported clinically diagnosed urinary tract stones was more common in the active CaD medication group than in the placebo group (hazard ratio: 1.17; 95% CI: 1.02, 1.34): 449 women in the CaD group and 381 women in the placebo group reported a stone during the trial. The rates of self-reported stones did not differ between various demographic, anthropomorphic, dietary, and other hypothesized risk factors according to randomization assignment. Neither the total calcium intake nor the use of calcium supplements at baseline was associated with the risk of stones. In sensitivity analyses that censored participants who were below 80% adherence, the findings were similar.
Daily supplementation with CaD for 7 y was associated with an increase in the number of self-reported urinary tract stones. These findings have implications for CaD supplement use. This trial was registered with the WHI at clinicaltrials.gov as NCT00000611.
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- All items in Kidney Stones and Vitamin D
- 2 grams of Calcium and Vit D reduce fractures but increase kidney stones - 2006 file
- IoM again fails to look at interactions - Nov 2010 which has the following chart
Various studies at the VitaminDWiki show problems with Calcium and Vitamin D above the dashed gray line
That is, the effect of 2,500 mg of Calcium with 4,000 IU of vitamin D is like taking 4X as much Calcium = 10,000 mg.