The effects of chronic acid loads in normal man: further evidence for the participation of bone mineral in the defense against chronic metabolic acidosis.

Lemann, Jacob; Litzow, JR; Ej, Lennon

doi:10.1172/jci105467

Cited by 541 publications

(255 citation statements)

References 7 publications

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“…Chronic metabolic acidosis causes mobilization of calcium carbonate from bone to act as a buffer. The carbonate combines with hydrogen and the calcium is excreted in the urine [107]. The acidosis is also buffered in the protein of bone matrix [108].…”

Section: Metabolic Disturbancementioning

confidence: 99%

Augmentation cystoplasty

Greenwell¹,

Venn²,

Mundy³

2001

BJU International

193

137

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Section: Metabolic Disturbancementioning

confidence: 99%

Augmentation cystoplasty

Greenwell¹,

Venn²,

Mundy³

2001

BJU International

193

137

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“…That can occur when the summed endogenous and exogenous non-carbonic acid load to the body exceeds that of the corresponding base load for a long period of time (years). The resulting chronic metabolic acidosis elicits osteoclastic bone resorption, which releases bone mineral, including calcium and its accompanying basic anions [8][9][10][11][12][13][14][15]. Most Americans suffer from a low-grade chronic metabolic acidosis owing to the fact that the typical American diet is net acid producing, that is, it produces non-carbonic acid in excess of base (alkali, bicarbonate) [16,17].…”

Section: The Skeleton's Role In Mineral Homeostasismentioning

confidence: 99%

A neglected requirement for optimizing treatment of age-related osteoporosis: Replenishing the skeleton’s base reservoir with net base-producing diets

Sebastián

Frassetto

2016

Medical Hypotheses

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a b s t r a c tOsteoporosis is a disorder of bone in which the mass of the bone is reduced and the bone's architecture at the microscopic level is disordered. Together those abnormalities predispose affected individuals to experience fractures despite only minimal trauma (i.e., fragility fractures). Age related osteoporosis is a common type of osteoporosis that occurs with aging in both men and women usually beginning after the age of peak bone mass. Research has found that the disorder can be partially reversed by reducing the net amount of acid that is produced when consuming typical Western diets. However, the amelioration that results has not been so dramatic or so consistent that physicians have adopted the procedure as part of the standard treatment for age-related osteoporosis. We propose that reducing the net acid load from the diet is not sufficient to reverse age related osteoporosis because it fails to supply base needed to restore the large amount of base in bone that had been lost by reacting with the net acid load of the diet that had been consumed for years or decades. Reducing the net acid load from the diet might be expected to have little ameliorative effect or merely slow the progression of the disorder. We hypothesize that both to restore osteoporotic bone to, or nearly to, its pre-disease state, as well as to eliminate the risk of fragility fractures, requires consuming diets that produce net amounts of base to restore the base lost from years to decades of consuming diets that produce net amounts of acid. We hypothesize also that the excess base and attendant subclinical metabolic alkalosis will both stimulate the cellular process of bone formation and suppress the cellular process of bone resorption, and thereby implement the restorative process.Ó 2016 Elsevier Ltd. All rights reserved. Introduction Functions of the skeletonThe human skeleton is an adaptive, self-organizing, multifunctional organ-system vital to human health. It functions (a) as a structure supporting body movement through connections with skeletal muscles, and as trauma-defense through its structural surrounding of vital organs, (b) it contributes to cellular oxygenation throughout the body by generating and distributing red blood cells systemically via the circulation; (c) it contributes to systemic calcium and phosphorus homeostasis in virtue of its large reservoir of labile calcium and phosphorus; (d) it contributes to systemic acid-base homeostasis in virtue of its large reservoir of labile base equivalents residing in calcium hydroxyapatite, the major mineral component of bone; and, (e) contributes to the integration of body physiology through two-way endocrine communication with numerous organ systems of the body (pp. 3-4 [1]) (p. 3 [2]). Each subsystem of the human skeleton adapts to changing environmental conditions-rendering the skeleton a complex adaptive system. Bone remodelingThroughout one's life the skeleton continually remodels itself in response to changing mechanical loads and mechanical microdamage, thro...

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“…The acid load that is produced by a high-protein diet or ingestion of ammonium chloride has been shown to increase urine calcium excretion (77)(78)(79)(80)(81)(82)(83). Alkali treatment alone or given together with a high-protein diet or ammonium chloride reduces urine calcium excretion and improves calcium balance (77,78,80 -84).…”

Section: Kidneymentioning

confidence: 99%