Relationship between low serum vitamin D status and urinary tract infection in children: a case–control study

ABSTRACT

Background

A link between vitamin D deficiency and susceptibility to bacterial and viral infections has recently been suggested.

Aim

To investigate a possible association between vitamin D deficiency and urinary tract infection (UTI).

Methods

A case–control study was undertaken comprising 75 children aged 2–7 years with UTI (cases) compared with 75 healthy controls in terms of serum 25 hydroxyvitamin D [25(OH)D] levels. Serum 25(OH)D levels were measured using a chemiluminescence assay. For cases, dimercaptosuccinic acid (DMSA) renal scan was used as the gold standard to distinguish between acute lower UTI (cystitis) and acute pyelonephritis.

Results

Median (IQR) 25(OH)D levels were lower in the UTI group [14.5 ng/mL (9.4–18.8)] than in the controls [27 ng/mL (22.4–39.0)] (p< 0.001). In addition, the prevalence of 25(OH)D levels <20 ng/mL was higher in the children with UTI than in the controls (68% vs 18%) (p< 0.001). There was a statistically significant difference between the cystitis and pyelonephritis groups in mean (SD) serum 25(OH)D levels—18.76 (9.35) ng/mL vs 13.94 (6.97) ng/mL, p< 0.05, respectively.

Conclusion

Low serum vitamin D is associated with UTI and supports the hypothesis that children with low vitamin D levels could be at greater risk of UTI.

KEYWORDS:

• 25-hydroxyvitamin D
• urinary tract infection
• pyelonephritis
• cystitis

Acknowledgments

This study was undertaken by Sarvin Pashapour in partial fulfillment of the requirements for a degree in paediatrics at Urmia University of Medical Sciences. We would like to thank the staff of the Motahari Educational Hospitals for cooperation in data collection and the parents of the children for their cooperation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The research was supported by Urmia University of Medical Sciences and health services;Urmia University of medical sciences. This paragraph should be moved to after Discussion.

Notes on contributors

Morteza Ghasemnejad-Berenji

Sarvin Pashapour collected and analysed the data, reviewed the literature and wrote the manuscript; Hashem Mahmoudzadeh supervised the study and data collection; Ahmad Ali Nikibakhsh supervised the patient management and data collection; Morteza Ghasemnejad-Berenji planned the study, supervised the data collection and analysis, the literature review, critically reviewed the manuscript and approved the final version.