Buşra GÜRPINAR, Bağdagül YAVAŞ AKSU, Zeynep YÜRÜK YILDIRIM, Emine ÇALIŞKAN, Zuhal BAYRAMOĞLU, Gülbin GÖKÇAY, Alev YILMAZ
Southern Clinics of Istanbul Eurasia - 2026;37(3):319-327
Objective: Vitamin D prophylaxis (400 IU/day) is recommended for all children, at least during the first year of life. This prophylaxis is usually ceased in children with nephrolithiasis despite limited evidence. This study aimed to determine whether the cessation of vitamin D prophylaxis affects the number and size of stones in young children with nephrolithiasis. Methods: This prospective study evaluated children aged<3 years who were referred to a pediatric nephrology center for nephrolithiasis. Renal ultrasonography was performed by a single experienced pediatric radiologist. Twenty-eight children (17 males, 60.7%) with persistent nephrolithiasis were enrolled. Vitamin D prophylaxis was ceased during the first 3 months (P1) and subsequently administered for 3 months (P2). The number and size of stones were assessed using ultrasonography at the end of both periods. Results: The mean age at the initial ultrasonography was 13.7+/-10.7 (range, 2.7-39.4) months. Serum creatinine, calcium levels were normal in all patients, and none had vitamin D hypervitaminosis. Metabolic abnormalities were detected in 12 patients (42.9%), most commonly hypercalciuria (n=8), hypocitraturia (n=7). Stone number and size decreased significantly during both P1 and P2. None of the 12 children who were stone-free at the end of P1 developed new stones after vitamin D prophylaxis was reintroduced during P2. Reduction in stone number was more frequent in younger children (p=0.01), whereas no other clinical or laboratory parameters were associated with stone improvement. Conclusions: Routine cessation of vitamin D prophylaxis may not be necessary in children with nephrolithiasis when close ultrasonographic monitoring is performed.
