Journal article
Urinary tract stone occurrence in the Women's Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements
The American journal of clinical nutrition, Vol.94(1), pp.270-277
07/01/2011
DOI: 10.3945/ajcn.110.003350
PMCID: PMC3127502
PMID: 21525191
Abstract
Background: 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.
Objective: We examined the correlates of urinary tract stone occurrence in the CaD arm of the WHI trial.
Design: 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.
Results: 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.
Conclusions: 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. Am J Clin Nutr 2011;94:270-7.
Details
- Title: Subtitle
- Urinary tract stone occurrence in the Women's Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements
- Creators
- Robert B. Wallace - University of IowaJean Wactawski-Wende - Buffalo State UniversityMary Jo O'Sullivan - University of MiamiJoseph C. Larson - Fred Hutch Cancer CenterBarbara Cochrane - University of WashingtonMargery Gass - University of CincinnatiKamal Masaki - University of Hawaiʻi at Mānoa
- Resource Type
- Journal article
- Publication Details
- The American journal of clinical nutrition, Vol.94(1), pp.270-277
- DOI
- 10.3945/ajcn.110.003350
- PMID
- 21525191
- PMCID
- PMC3127502
- NLM abbreviation
- Am J Clin Nutr
- ISSN
- 0002-9165
- eISSN
- 1938-3207
- Publisher
- Amer Soc Clinical Nutrition
- Number of pages
- 8
- Grant note
- N01WH22110; 24152; 32100-2; 32105-6; 32108-9; 32111-13; 32115; 32118-32119; 32122; 42107-26; 42129-32; 44221 / National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) N01WH032111 / WOMEN'S HEALTH INITIATIVE - OFFICE OF THE DIRECTOR NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 07/01/2011
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363662102771
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