Abstract

Purpose: The goal of our research study is to prove that Vit D supplementation on children with frequent UTI has clinical effective role in the treatment and pathogenesis of the disease and that Vit D and UTI are strongly clinically linked.

Methods: This is case-control research study, 130 children aged 0 - 18 y with recurrent UTI were involved (case group) and compared with 130 children (control group) considering serum Vit D level measurement and following up participants for 9 months. ELISA (enzyme-linked immunosorbent assay) was used to measure serum Vit D level. The results data were analyzed to compare between both case and control groups.

Results: In our study and among 130 children aged 0 - 18 y with recurrent UTI (case group), 35 (27%) were boys and 95 (73%) were girls, and in healthy participants (control group) 42 (32%) were boys and 88 (68%) were girls consequently. The mean serum Vit D level in the case group before starting this research study was (8 ng/ml) in 62% and the incidence of frequent UTI was more than 10 times/month in 79%; after administration of 1000 - 5000 IU of Vit D, a remarkable raise of Vit D (22ngml) in 59% with decline incidence and frequency (less than 3 times/month) of UTI has been reported in 74%.

Conclusion: In our case-control study, based on our results and data, we reported that Vit D supplementation in children with frequent UTI has very good clinical effective role in the treatment and elimination of the incidence of UTI in such cases. Adequate relatively high effective dose of Vit D (1000 IU - 5000 IU) must be administered in children with UTI according to age and severity, this supplementation has very significant key role to decline the incidence, frequency as well as the common clinical symptoms and signs of UTI in children aged 0 - 18 y.

Keywords: Children Aged 0 - 18y; Vit D Adequate Dose; Recurrent UTI

References

1. National Institution for Health and Care Excellence. "Urinary tract infection (recurrent): antimicrobial prescribing” (2018). 
2. Elder JS. “Urinary tract infections”. In: Kliegman RM, Stanton BF, St.Geme JW III, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 20^th ed. Philadelphia (PA): Elsevier Saunders, (2016): 2554- 2563.
3. Bensman A., et al. “Urinary tract infection. In: Avner ED, Harman WE, Niaudet P, Yoshikawa N, editors”. Pediatric Nephrology. 6^th ed. Berlin: Springer (2009): 1007-1025.
4. Wald ER. “Cystitis and pyelonephritis”. In: Feigin RD, Cherry J, Demmler-Harrison GL, Kaplan SL, editors. Feigin and Cherry’s text book of infectious diseases. 6^th ed. Philadelphia (PA): Elsevier Saunders (2009): 554-569.
5. Ayazi P., et al. “Comparison of procalcitonin and C-reactive protein tests in children with urinary tract infection”. Iranian Journal of Pediatrics 19 (2009): 381-386. 
6. Ayazi P., et al. “The effect of vitamin A on renal damage following acute pyelonephritis in children”. European Journal of Pediatrics 170 (2011): 347-350.
7. Stokland E., et al. “Renal damage one year after first urinary tract infection: role of dimercaptosuccinic acid scintigraphy”. The Journal of Pediatrics 129 (1996): 815-820. 
8. Rushton HG. “Urinary tract infections in children. Epidemiology, evaluation, and management”. Pediatric Clinics of North America 44 (1997): 1133-1169.
9. Leonardo CR., et al. “Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction”. Pediatric Nephrology 22 (2007): 1891-1896. 
10. Yang J., et al. “Low serum 25- hydroxyvitamin D level and risk of urinary tract infection in infants”. Medicine (Baltimore) 95 (2016): e4137.
11. Jorde R., et al. “Prevention of urinary tract infections with vitamin D supplementation 20,000IU per week for five years. Results from an RCT including 511 subjects”. Infectious Diseases (Lond) 48 (2016): 823-828. 
12. Katikaneni R., et al. “Breastfeeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation increases the risk by 76%”. Clinical Pediatrics (Phila) 48 (2009): 750-755. 
13. Guillot X., et al. “Vitamin D and inflammation”. Joint Bone Spine 77 (2010): 552-557.
14. Holick MF. “Vitamin D: extraskeletal health”. Endocrinology and Metabolism Clinics of North America 39 (2010): 381-400. 
15. Lagishetty V., et al. “Vitamin D metabolism and innate immunity”. Molecular and Cellular Endocrinology 347 (2011): 97-105. 
16. Hewison M. “Antibacterial effects of vitamin D”. Nature Reviews Endocrinology 7 (2011): 337-345. 
17. Wilkinson RJ., et al. “Influence of vitamin D deficiency and vitamin D receptor polymorphisms on tuberculosis among Gujarati Asians in west London: a case-control study”. Lancet 355 (2000): 618-621. 
18. Muhe L., et al. “Case-control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children”. Lancet 349 (1997): 1801-1814. 
19. Laaksi I., et al. “An association of serum vitamin D concentrations”. 86.3 (2007): 714-717. 
20. McNally JD., et al. “Vitamin D deficiency in young children with severe acute lower respiratory infection”. Pediatric Pulmonology 44 (2009): 981-988.
21. Schluter P., et al. “Indices and perception of crowding in Pacific households domicile within Auckland, New Zealand: findings from the Pacific Islands Families Study”. New Zealand Medical Journal 120 (2007): U2393.
22. Holick MF. “Vitamin D deficiency”. The New England Journal of Medicine 357 (2007): 266-281. 
23. Nseir W., et al. “The association between serum levels of vitamin D and recurrent urinary tract infections in premenopausal women”. International Journal of Infectious Diseases 17 (2013): e1121-1124. 
24. Nielsen KL., et al. “Role of urinary cathelicidin LL-37 and human β-defensin 1 in uncomplicated Escherichia coli urinary tract infections”. Infection and Immunity 82 (2014): 1572-1578. 
25. Kwon YE., et al. “Vitamin D deficiency is an independent risk factor for urinary tract infections after renal transplants”. Medicine 94 (2015): e594.
26. Tekin M., et al. “The association between vitamin D levels and urinary tract infection in children”. Hormone Research in Paediatrics 83 (2015): 198-203.
27. ÖvünçHacıhamdioğlu D., et al. “The association between serum 25-hydroxy vitamin D level and urine cathelicidin in children with a urinary tract infection”. Journal of Clinical Research İn Pediatric Endocrinology 8 (2016): 325-329.
28. Liu PT., et al. “Toll-Like Receptor Triggering of a Vitamin D-Mediated Human Antimicrobial Response”. Science 311.5768 (2006): 1770-1773. 
29. Wang TT., et al. “Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression”. The Journal of Immunology 173 (2004): 2909-2912. 
30. Cantorna MT., et al. “The paradoxical effects of vitamin D on type 1 mediated immunity”. Molecular Aspects of Medicine 29 (2008): 369-375. 
31. White JH. “Vitamin D as an inducer of cathelicidin antimicrobial peptide expression: past, present and future”. The Journal of Steroid Biochemistry and Molecular Biology 121 (2010): 234-238. 
32. Chromek M., et al. “The antimicrobial peptide cathelicidin protects the urinary tract against invasive bacterial infection”. Nature Medicine 12 (2006): 636-641. 
33. Lai Y and Gallo RL. “AMPed up immunity: how antimicrobial peptides have multiple roles in immune defense”. Trends in Immunology 30 (2009): 131-141. 
34. Zasloff M. “Antimicrobial peptides, innate immunity, and the normally sterile urinary tract”. Journal of the American Society of Nephrology 18 (2007): 2810-2816. 
35. White JH. “Vitamin D signaling, infectious diseases, and regulation of innate immunity”. Infection and Immunity 76 (2008): 3837-3843. 
36. Deluca HF and Cantorna MT. “Vitamin D: its role and uses in immunology”. The FASEB Journal 15 (2001): 2579-2585. 
37. Yaqob S Khajik “Colic and Anal Fissure in Infancy: The Missing Significant Correlation”. EC pediatrics 4.3 (2017): 65-69
38. Qazaryan KSY. “The clinical link of preschoolers’ picky eating behavior with their growth, development, nutritional status, and physical activity in Iraq/Kurdistan region”. Current Neurology and Neuroscience Reports 2 (2019).  
39. Yaqob K. “P512 Children and healthy eating how do they understand it”. Archives of Disease in Childhood 104 (2019): A358.
40. Anand N., et al. “Vitamin D and periodontal health: Current concepts”. Journal of Indian Society of Periodontology 17.3 (2013): 302-308. 

Citation

Citation: Khajik Sirob Yaqob Qazaryan., et al. “The Clinical Link and Therapeutic Impacts of Adequate High Vitamin D Supplementation Among Children with Recurrent Urinary Tract Infection in Kurdistan Region/Iraq: A Case-Control Study". Acta Scientific Nutritional Health 4.3 (2020): 67-72.

Copyright

Copyright: © 2020 Khajik Sirob Yaqob Qazaryan., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.