2299 INCREASING DOSES OF VITAMIN D SUPPLEMENTATION ARE ASSOCIATED WITH DECREASED RISK OF NEPHROLITHIASIS IN POST GASTRIC BYPASS SURGERY
Bibliographic record
Abstract
You have accessJournal of UrologyStone Disease: Basic Research II1 Apr 20122299 INCREASING DOSES OF VITAMIN D SUPPLEMENTATION ARE ASSOCIATED WITH DECREASED RISK OF NEPHROLITHIASIS IN POST GASTRIC BYPASS SURGERY Patrick Scheffler, Mark Dunn, Nicolas V. Christou, Ross E. Andersen, and Sero Andonian Patrick SchefflerPatrick Scheffler Montreal, Canada More articles by this author , Mark DunnMark Dunn Montreal, Canada More articles by this author , Nicolas V. ChristouNicolas V. Christou Montreal, Canada More articles by this author , Ross E. AndersenRoss E. Andersen Montreal, Canada More articles by this author , and Sero AndonianSero Andonian Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2479AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent studies have indicated a potential increased risk of nephrolithiasis post gastric bypass surgery. This study aimed to examine the incidence of nephrolithiasis post gastric bypass surgery (RYGB) in relation to vitamin D supplementation. METHODS A telephone questionnaire assessing current health status, history of nephrolithiasis (pre and post RYGB) and their risk factors [(age, sex, BMI diabetes mellitus (DM), coronary artery disease (CAD), hypertension (HTN), and history of renal disease (RD)] was administered to 200 consecutive patients who had RYGB 5 to 15 years earlier. Specific dosages of calcium and vitamin D supplementation were assessed. For statistical analysis, patients were collapsed into two groups based on clinical outcome (post-RYGB stone-formers and non-formers). RESULTS The mean follow-up was 10.1 years, the overall incidence of nephrolithiasis was 10.5%. Pre-RYGB, 8% of patients reported nephrolithiasis whereas post-RYGB, 12.5% reported nephrolithiasis, of which 90.5% constituted de novo post-RYGB stone formers. Post-RYGGB stone formers reported significantly higher history of renal insufficiency when compared with non-formers (23.8% vs 2.2 %; p<0.001). There were no significant differences between non-formers and stone formers in mean calcium (200mg vs 200 mg, p>0.05) or vitamin D (400 IU vs 600IU; p>0.05) supplementation. However, when risk factors for nephrolithiasis (age > 40, BMI > 30, male sex, CAD, DM, HTN, RD) were analyzed with the different vitamin D doses in a logistic regression model, increasing doses of vitamin D supplementation was found to be associated with decreasing OR of developing post-RYGB nephrolithiasis. For patients without vitamin D supplementation, these nephrolithiasis risk factors predicted post-RYGB stone formation with an OR of 2.29 (p<0.05). This effect was dose dependent, and supplementation of vitamin D at a dose of 1000IU abolished the lithogenic effect. No such effects were found for calcium. CONCLUSIONS Incidence of nephrolithiasis is high post-RYGB at a rate of 12.5%. This risk is mitigated in a dose-dependent manner by vitamin D supplementation, and is optimized at 1000IU. Prospective trials are needed to explore the role that vitamin D may play in reducing nephrolithiasis. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e927-e928 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick Scheffler Montreal, Canada More articles by this author Mark Dunn Montreal, Canada More articles by this author Nicolas V. Christou Montreal, Canada More articles by this author Ross E. Andersen Montreal, Canada More articles by this author Sero Andonian Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".