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. 2016 Mar;67(3):400-7.
doi: 10.1053/j.ajkd.2015.09.005. Epub 2015 Oct 14.

Total, Dietary, and Supplemental Vitamin C Intake and Risk of Incident Kidney Stones

Pietro Manuel Ferraro  1 , Gary C Curhan  2 , Giovanni Gambaro  3 , Eric N Taylor  4
Affiliations

Total, Dietary, and Supplemental Vitamin C Intake and Risk of Incident Kidney Stones

Pietro Manuel Ferraro et al. Am J Kidney Dis. 2016 Mar.

Abstract

Background: Previous studies of vitamin C and kidney stones were conducted mostly in men and either reported disparate results for supplemental and dietary vitamin C or did not examine dietary vitamin C.

Study design: Prospective cohort analysis.

Setting & participants: 156,735 women in the Nurses' Health Study (NHS) I and II and 40,536 men in the Health Professionals Follow-up Study (HPFS).

Predictor: Total, dietary, and supplemental vitamin C intake, adjusted for age, body mass index, thiazide use, and dietary factors.

Outcomes: Incident kidney stones.

Results: During a median follow-up of 11.3 to 11.7 years, 6,245 incident kidney stones were identified. After multivariable adjustment, total vitamin C intake (<90 [reference], 90-249, 250-499, 500-999, and ≥1,000mg/d) was not significantly associated with risk for kidney stones among women, but was among men (HRs of 1.00 [reference], 1.19 [95% CI, 0.99-1.46], 1.15 [95% CI, 0.93-1.42], 1.29 [95% CI, 1.04-1.60], and 1.43 [95% CI, 1.15-1.79], respectively; P for trend = 0.005). Median total vitamin C intake for the 500- to 999-mg/d category was ∼700mg/d. Supplemental vitamin C intake (no use [reference], <500, 500-999, and ≥1,000mg/d) was not significantly associated with risk for kidney stones among women, but was among men (HR, 1.19 [95% CI, 1.01-1.40] for ≥1,000mg/d; P for trend = 0.001). Dietary vitamin C intake was not associated with stones among men or women, although few participants had dietary intakes > 700mg/d.

Limitations: Nutrient intakes derived from food-frequency questionnaires, lack of data on stone composition for all cases.

Conclusions: Total and supplemental vitamin C intake was significantly associated with higher risk for incident kidney stones in men, but not in women.

Keywords: Kidney disease; ascorbic acid; calcium oxalate; diet; food-frequency questionnaire (FFQ); gender difference; incident kidney stone; kidney stone formation; nutrition; risk factor; supplements; urinary oxalate excretion; urolithiasis; vitamin C.

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Figures

Figure 1
Figure 1. Restricted cubic spline of total vitamin C intake and risk of incident kidney stones: Nurses’ Health Studies I and II
Model adjusted for age, BMI, thiazide use, use of calcium supplements, intake of calcium, sodium, potassium, magnesium, fructose, oxalate, phytate, animal protein, total fluid and alcohol.
Figure 2
Figure 2. Restricted cubic spline of total vitamin C intake and risk of incident kidney stones: Health Professionals Follow-up Study
Model adjusted for age, BMI, thiazide use, use of calcium supplements, intake of calcium, sodium, potassium, magnesium, fructose, oxalate, phytate, animal protein, total fluid and alcohol.
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References

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