Association between calcium and vitamin D supplementation and increased risk of kidney stone formation in patients with osteoporosis in Southwest China: a cross-sectional study

BMJ Open. 2025 Feb 16;15(2):e092901. doi: 10.1136/bmjopen-2024-092901.

Abstract

Objectives: This cross-sectional study aims to evaluate the association between calcium and vitamin D supplementation for osteoporosis treatment and the development of kidney stones while investigating the impact of urinary calcium excretion on kidney stone risk among patients receiving this supplementation treatment.

Design: The study involved collecting data from 204 Chinese Han patients aged 50-89 with osteoporosis in the southwest region of China. These patients had been on daily doses of 600 mg of calcium carbonate and 0.5 µg alfacalcidol for at least 1 year. The study employed univariate analysis and multivariable logistic regression to identify risk factors for kidney stones, with independent t-tests used to compare differences between groups.

Setting: Data were collected from patients in the southwest region of China, covering the period from July 2019 to December 2023.

Participants: The study included 204 patients with osteoporosis, all of whom had been receiving the specified calcium and vitamin D supplements for the duration of the study.

Results: The study found that a history of recurrent kidney stones was an independent risk factor for the development of kidney stones. Patients with kidney stones who had a history of recurrent stones exhibited significantly higher levels of 24-hour urinary calcium excretion (1.00±0.62 vs 0.57±0.54, p=0.026) compared with those without such a history.

Conclusions: The results suggest that a history of recurrent kidney stones independently increases the risk of kidney stones in patients undergoing calcium and vitamin D supplementation for osteoporosis, likely due to increased urinary calcium excretion.

Keywords: Aging; Calcium & bone; Cross-Sectional Studies; Kidney & urinary tract disorders.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Density Conservation Agents* / administration & dosage
  • Bone Density Conservation Agents* / adverse effects
  • Bone Density Conservation Agents* / therapeutic use
  • Calcium Carbonate* / administration & dosage
  • Calcium Carbonate* / adverse effects
  • Calcium* / adverse effects
  • Calcium* / urine
  • China / epidemiology
  • Cross-Sectional Studies
  • Dietary Supplements* / adverse effects
  • Female
  • Humans
  • Hydroxycholecalciferols / administration & dosage
  • Hydroxycholecalciferols / adverse effects
  • Kidney Calculi* / chemically induced
  • Kidney Calculi* / epidemiology
  • Kidney Calculi* / etiology
  • Male
  • Middle Aged
  • Osteoporosis* / drug therapy
  • Risk Factors
  • Vitamin D* / administration & dosage
  • Vitamin D* / adverse effects
  • Vitamin D* / therapeutic use

Substances

  • Vitamin D
  • Calcium
  • Bone Density Conservation Agents
  • Calcium Carbonate
  • alfacalcidol
  • Hydroxycholecalciferols