eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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1/2018
vol. 14
 
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abstract:
Clinical research

Vitamin D deficiency is associated with urinary tract infection in children

Sherein Abdelhamid Shalaby, Nesrein Mosad Handoka, Rasha Emad Amin

Arch Med Sci 2018; 14, 1: 115–121
Online publish date: 2016/10/26
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Introduction: In humans, vitamin D has been shown to play a role in infectious diseases, but its association with acquisition and a complicated course of febrile urinary tract infections (UTIs) has not been investigated. We aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D3) levels and the risk of first time febrile UTI in children.

Material and methods: This prospective case-control study included 50 children with first febrile UTI, with no risk factors for UTI, and 50 age- and sex-matched healthy siblings as controls. White blood cell count, serum C-reactive protein, calcium, phosphorus, alkaline phosphatase and parathormone were measured in all studied children. Vitamin D status was determined by measuring plasma 25(OH)D3 level. Deficiency was defined as a plasma 25(OH)D3 level ≤ 25 nmol/l.

Results: Children with UTI had significantly lower mean serum levels of 25(OH)D3 (10.5 ±2.7 nmol/l) than those of controls (25.9 ±5.6 nmol/l) (p < 0.05). Patients with lower UTI had significantly higher serum levels of 25(OH)D3 compared to those with acute pyelonephritis (12.4 ±2.59 vs. 8.2 ±3.2 nmol/l; p < 0.001). Mean serum levels of 25(OH)D3 were significantly lower (p = 0.001) in the female patients compared with males, and this difference was not found within the control group. Multivariate analysis showed that a serum 25(OH)D3 level of ≤ 25 nmol/l is associated with UTI (OR = 1.94, 95% CI: 1.61–2.82; p = 0.04).

Conclusions: Vitamin D deficiency (≤ 25 nmol/l) was an independent risk factor for UTI in children.
keywords:

children, urinary tract infection, 25-hydroxyvitamin D, vitamin D deficiency

references:
Shaikh N, Ewing AL, Bhatnagar S, Hoberman A. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics 2010; 126: 1084-91.
Finnell SM, Carroll AE, Downs SM. Subcommittee on Urinary Tract I. Technical report-diagnosis and management of an initial UTI in febrile infants and young children. Pediatrics 2011; 128: e749-70.
Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011; 128: 595-610.
American Academy of Pediatrics Committee on Quality Improvement, Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 1999; 103: 843-52.
Keren R, Carpenter MA, Hoberman A, et al. Rationale and design issues of the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) Study. Pediatrics 2008; 122: 240-50.
Katikaneni R, Ponnapakkam T, Ponnapakkam A, Gensure R. Breast feeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation increases the risk by 76%. Clin Pediatr 2009; 48: 750-5.
Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-81.
Gombart AF. The vitamin D-antimicrobial peptide pathway and its role in protection against infection. Future Microbiol 2009; 4: 1151-65.
Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metabol 2010; 95: 471-8.
Jeng L, Yamshchikov AV, Judd SE, et al. Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis. J Transl Med 2009; 7: 28.
Canning MO, Grotenhuis K, de Wit H, Ruwhof C, Drexhage HA. 1-alpha,25-Dihydroxyvitamin D3 (1,25(OH)2D3) hampers the maturation of fully active immature dendritic cells from monocytes. Eur J Endocrinol 2001; 145: 351-7.
Bartley J. Vitamin D: emerging roles in infection and immunity. Expert Rev Anti Infect Ther 2010; 8: 1359-69.
Wang TT, Nestel FP, Bourdeau V, et al. Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J Immunol 2004; 173: 2909-12.
Liu PT, Stenger S, Li H, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006; 311: 1770-3.
Hertting O, Holm Å, Lüthje P, et al. Vitamin D induction of the human antimicrobial peptide cathelicidin in the urinary bladder. Bereswill S (ed.). PLoS One 2010; 5: e15580.
Toubi E, Shoenfeld Y. The role of vitamin D in regulating immune responses. Isr Med Assoc J 2010; 12: 174-5.
Edefonti A, Tel F, Testa S, De Palma D. Febrile urinary tract infections: clinical and laboratory diagnosis, imaging, and prognosis. Semin Nucl Med 2014; 44: 123-8.
Williams GJ, Macaskill P, Chan SF, Turner RM, Hodson E, Craig JC. Absolute and relative accuracy of rapid urine tests for urinary tract infection in children: a meta-analysis. Lancet Infect Dis 2010; 10: 240-50.
National Institute for Health and Care Excellence. Urinary tract infection in under 16s: diagnosis and management 2015. Available from URL: http://www.guidelines.co.uk/nice/uti-children
Scharla SH, Scheidt-Nave C, Leidig G, et al. Lower serum 25-hydroxyvitamin D is associated with increased bone resorption markers and lower bone density at the proximal femur in normal females: a population-based study. Exp Clin Endocrinol Diabetes 1996; 104: 289-92.
Scharla SH. Prevalence of subclinical vitamin D deficiency in different European countries. Osteoporos Int 1998; 8: 7-12.
Soliman GT, Ali BA, Mohamed AA, Mahmoud AM, Abdellatif AA. Assessment of vitamin D status in Egyptian children with type-1 diabetes mellitus. J Diabetes Metab 2015; 6: 573.
Youssef DA, Ranasinghe T, Grant WB, Peiris AN. Vitamin D’s potential to reduce the risk of hospital-acquired infections. Dermatoendocrinology 2012; 4: 167-75.
Zasloff M. Antimicrobial peptides of multicellular organisms. Nature 2002; 415: 389-95.
Chromek M, Slamova Z, Bergman P, et al. The antimicrobial peptide cathelicidin protects the urinary tract against invasive bacterial infection. Nature Med 2006; 12: 636-41.
Norden CW, Green GM, Kass EH. Antibacterial mechanisms of the urinary bladder. J Clin Investig 1968; 47: 2689-700.
Justice SS, Hung C, Theriot JA, et al. Differentiation and developmental pathways of uropathogenic Escherichia coli in urinary tract pathogenesis. Proc Natl Acad Sci USA 2004; 101: 1333-8.
Aslan S, Akil I, Aslan G, Onay H, Ozyurt BC, Ozkinay F. Vitamin D receptor gene polymorphism in children with urinary tract infection. Pediatr Nephrol 2012; 27: 417-21.
Nseir W, Taha M, Nemarny H, Mograbi J. The association between serum levels of vitamin D and recurrent urinary tract infections in premenopausal women. Int J Infect Dis 2013; 17: 1121-4.
Tekin M, Konca C, Celik V, et al. The association between vitamin D levels and urinary tract infection in children. Horm Res Paediatr 2015; 83: 198-203.
Darmawikarta D, Chen Y, Lebovic G, Birken CS, Parkin PC, Maguire JL. Total duration of breastfeeding, vitamin D supplementation, and serum levels of 25-hydroxyvitamin D. Am J Public Health 2016; 106: 714-9.
Abu Shady MM, Youssef MM, Salah El-Din EM, et al. Predictors of serum 25-hydroxyvitamin D concentrations among a sample of Egyptian schoolchildren. Sci World J 2016 in press doi:10.1155/2016/8175768.
Gurgoze MK, Akarsu S, Yilmaz E, et al. Proinflammatory cytokines and procalcitonin in children with acute pyelonephritis. Pediatr Nephrol 2005; 20: 1445-8.
Ayazi P, Mahyar A, Daneshi MM, Jahani Hashemi H, Pirouzi M, Esmailzadehha N. Diagnostic accuracy of the quantitative C-reactive protein, erythrocyte sedimentation rate and white blood cell count in urinary tract infections among infants and children. Malays J Med Sci 2013; 20: 40-6.
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