Urinary Calcium Excretion in Human Beings

Bleich, Howard L.; Moore, Mary Jean; Lemann, Jacob; Adams, Nancy D.; Gray, Richard W.

doi:10.1056/nejm197909063011008

Cited by 237 publications

(34 citation statements)

References 68 publications

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“…Other studies did not qualify for the meta-analysis because the urine collection was for periods shorter than 24 h (43, 84 -91), all of the subjects had a chronic condition (92)(93)(94)(95)(96)(97)(98)(99), subjects were in a state of weight loss (100,101), the studies only included children (15, 61, 63, 65-67, 69, 81, 87, 102-104), the studies only included animals (105-107), or they were in vitro animal bone studies (108 -121). The search also located numerous narrative review articles on the acid-ash hypothesis (5,7,8,13,(122)(123)(124)(125)(126)(127)(128)(129).…”

Section: Description Of Studiesmentioning

confidence: 99%

Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid-ash diet hypothesis

Fenton

Eliasziw

Lyon

et al. 2008

The American Journal of Clinical Nutrition

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Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid-ash diet hypothesis [1][2][3][4] Tanis R Fenton, Michael Eliasziw, Andrew W Lyon, Suzanne C Tough, and David A Hanley ABSTRACT Background: The acid-ash diet hypothesis of osteoporosis suggests that acid from the modern diet causes a demineralization of the skeleton, and mobilized bone calcium is excreted. A systematic approach has not been used to summarize the findings of the numerous studies about the hypothesis. Objectives: The purpose of this meta-analysis was to estimate the quantity of net acid excretion and calciuria associated with the modern diet, to assess the association between acid excretion and calcium excretion, and to assess the influence of urine preservatives on calcium measurement. Design: We systematically searched for trials of the acid-ash hypothesis and conducted a meta-analysis. Results: Twenty-five of 105 studies met the inclusion criteria. The estimated quantity of net acid excretion from the weighted average of the control diets from 11 studies was 47 mEq/d. The increase in urinary calcium with a change in renal net acid excretion depended on whether the urine was acidic or alkaline (P 0.001). A significant linear relation was observed between net acid excretion and calcium excretion for both acidic and alkaline urine (P 0.001). The estimated change in urine calcium associated with a change of 47 mEq of net acid excretion in acidic urine was 1.6 mmol/d (66 mg/d) of calcium. Conclusion: Evidence suggests a linear association between changes in calcium excretion in response to experimental changes in net acid excretion. However, this finding is not evidence that the source of the excreted calcium is bone or that this calciuria contributes to the development of osteoporosis.

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Section: Description Of Studiesmentioning

confidence: 99%

Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid-ash diet hypothesis

Fenton

Eliasziw

Lyon

et al. 2008

The American Journal of Clinical Nutrition

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“…(1,2) There are two major types of acidosis: (1) metabolic acidosis-reduction in pH of body fluids caused by reduction of bicarbonate concentration ([HCO 3 Ϫ ]); and (2) respiratory acidosis-reduction in pH of body fluid caused by an increase in partial pressure of carbon dioxide (P CO 2 ), that is, hypercapnia. Metabolic acidosis increases osteoclastic bone resorption, (3,4) accelerates physicochemical dissolution of bone minerals, (5,6) is associated with increases in bone resorption and urinary calcium (Ca) excretion, (7,8) and decreases in bone formation (9) and bone mineral content. (10,11) Metabolic acidosis may play a key role in the bone loss associated with a number of metabolic bone diseases such as renal osteodystrophy (12)(13)(14) and osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

Bone Loss in Patients with Untreated Chronic Obstructive Pulmonary Disease Is Mediated by an Increase in Bone Resorption Associated with Hypercapnia

Dimai

Domej

Leb

et al. 2001

Journal of Bone and Mineral Research

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This study sought to determine whether the bone loss in untreated chronic obstructive pulmonary disease (COPD) is associated with hypercapnia and/or respiratory acidosis. Bone mineral density (BMD) measured at the distal forearm of the nondominant arm (with peripheral quantitative computed tomography [pQCT]) and serum markers of bone turnover were determined in 71 male patients with untreated COPD and 40 healthy male subjects who matched the patients in age, weight, and body mass index (BMI). The COPD patients, compared with controls, had reduced pulmonary functions, lower arterial pH, and elevated arterial partial pressure of CO 2 (P CO 2 ). The BMD (in T score) was significantly lower in COPD patients than that in control subjects (؊1.628 ؎ 0.168 vs. ؊0.058 ؎ 0.157; p < 0.001). The BMD of COPD patients correlated positively with arterial pH (r ‫؍‬ 0.582; p < 0.001), negatively with P CO 2 (r ‫؍‬ ؊0.442; p < 0.001), and negatively with serum cross-linked telopeptide of type I collagen (ICTP), a bone resorption marker (r ‫؍‬ ؊0.444; p < 0.001) but not with serum osteocalcin, a bone formation marker. Serum ICTP, but not osteocalcin, correlated with P CO 2 (r ‫؍‬ 0.593; p < 0.001) and arterial pH (r ‫؍‬ ؊0.415; p < 0.001). To assess the role of hypercapnia, COPD patients were divided into the hypercapnic (P CO 2 > 45 mm Hg; n ‫؍‬ 35) and eucapnic (P CO 2 ‫؍‬ 35-45 mm Hg) group (n ‫؍‬ 36). Patients with hypercapnia had lower BMD, lower arterial pH, and higher serum ICTP than did patients with eucapnia. Arterial pH and serum ICTP of eucapnic patients were not different from those of controls. To evaluate the role of uncompensated respiratory acidosis, COPD patients with hypercapnia were subdivided into those with compensatory respiratory acidosis (pH > 7.35; n ‫؍‬ 20) and those with uncompensated respiratory acidosis (pH < 7.35; n ‫؍‬ 15). The BMD and serum ICTP were not different among the two subgroups. In conclusion, this study presents the first associative evidence that the bone loss in COPD is at least in part attributed to an increased bone resorption that is associated primarily with hypercapnia rather than uncompensated respiratory acidosis. (J Bone Miner Res 2001;16:2132-2141)

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“…Its main mechanism is ascribed to Ca precipitation with unabsorbed fatty acids (35) , which result in a less effective absorption (12) and consequent calcium loss in stools (25) . Also, a large supply of parenteral amino acid may induce excessive calcium loss by urine (4) . On the other hand, a preserved colon may play an important role in calcium absorption in patients with extensive small bowel resection (18) .…”

Section: Resultsmentioning

confidence: 99%

Copper and Magnesium Deficiencies in Patients With Short Bowel Syndrome Receiving Parenteral Nutrition or Oral Feeding

Braga¹,

Ferreira²,

Marchini³

et al. 2015

Arq. Gastroenterol.

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-Background -Patients with short bowel syndrome have significant fluid and electrolytes loss. Objective -Evaluate the mineral and electrolyte status in short bowel syndrome patients receiving intermittent parenteral nutrition or oral feeding. Methods -Twenty two adults with short bowel syndrome, of whom 11 were parenteral nutrition dependent (PN group), and the 11 remaining had been weaned off parenteral nutrition for at least 1 year and received all nutrients by oral feeding (OF group). The study also included 14 healthy volunteers paired by age and gender (control group). Food ingestion, anthropometry, serum or plasma levels of sodium, potassium, phosphorus, magnesium, calcium, zinc, iron and copper were evaluated. PN group subjects were evaluated before starting a new parenteral nutrition cycle. Results -The levels of sodium, potassium, phosphorus, calcium and zinc were similar between the groups. The magnesium value was lower in the PN group (1.0 ± 0.4 mEq /L) than other groups. Furthermore, this electrolyte was lower in the OF group (1.4 ± 0.3 mEq /L) when compared to the Control group (1.8 ± 0.1 mEq/L). Lower values of copper (69±24 vs 73±26 vs 109±16 µg/dL) were documented, respectively, for the PN and OF groups when compared to the control group. Conclusion -Hypomagnesemia and hypocupremia are electrolyte disturbances commonly observed in short bowel syndrome. Patients with massive intestinal resection require monitoring and supplementation in order to prevent magnesium and copper deficiencies.

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Urinary Calcium Excretion in Human Beings

Cited by 237 publications

References 68 publications

Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid-ash diet hypothesis

Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid-ash diet hypothesis

Bone Loss in Patients with Untreated Chronic Obstructive Pulmonary Disease Is Mediated by an Increase in Bone Resorption Associated with Hypercapnia

Copper and Magnesium Deficiencies in Patients With Short Bowel Syndrome Receiving Parenteral Nutrition or Oral Feeding

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