Urinary calcium is a determinant of bone mineral density in elderly men participating in the InCHIANTI study

Vezzoli, Giuseppe; Soldati, Laura; Arcidiacono, Teresa; Terranegra, Annalisa; Biasion, R.; Russo, Cosimo Roberto; Lauretani, Fulvio; Bandinelli, Stefania; Bartali, Benedetta; Cherubini, Antonio; Cusi, Daniele; Ferrucci, Luigi

doi:10.1111/j.1523-1755.2005.00302.x

Cited by 46 publications

(45 citation statements)

References 38 publications

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“…Our results contrast with those of prior smaller-sized studies. In the InChianti Study (n=595) (10), an association between serum calcium and 24-hour urinary calcium excretion was observed in men but not women. Peacock et al (20) found a positive association between serum calcium load and urinary calcium excretion in 72 men and women.…”

Section: Discussionmentioning

confidence: 95%

“…Hypercalciuria was extensively studied in relation to kidney stone formation (8) and osteoporosis (9,10). However, population-based data on urinary calcium excretion are scarce, and the relationship between serum calcium and urinary calcium excretion or between circulating 25(OH)D levels and urinary calcium excretion has surprisingly not been fully explored or remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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Association of Urinary Calcium Excretion with Serum Calcium and Vitamin D Levels

Rathod

Bonny

Guessous

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Population-based data on urinary calcium excretion are scarce. The association of serum calcium and circulating levels of vitamin D [25(OH)D 2 or D 3 ] with urinary calcium excretion in men and women from a population-based study was explored.Design, settings, participants, & measurements Multivariable linear regression was used to explore factors associated with square root-transformed 24-hour urinary calcium excretion (milligrams per 24 hours) taken as the dependent variable with a focus on month-specific vitamin D tertiles and serum calcium in the Swiss Survey on Salt Study.Results In total, 624 men and 669 women were studied with mean ages of 49.2 and 47.0 years, respectively (age range=15-95 years). Mean urinary calcium excretion was higher in men than in women (183.05 versus 144.60 mg/24 h; P,0.001). In adjusted models, the association (95% confidence interval) of square root urinary calcium excretion with protein-corrected serum calcium was 1.78 (95% confidence interval, 1.21 to 2.34) mg/24 h per milligram per deciliter in women and 0.59 (95% confidence interval, 20.11 to 1.29) mg/24 h per milligram per deciliter in men. Men in the third 25(OH)D 3 tertile had higher square root urinary calcium excretion than men in the first tertile (0.99; 95% confidence interval, 0.36 to 1.63 mg/24 h per nanogram per milliliter), and the corresponding association was 0.32 (95% confidence interval, 20.22 to 0.85) mg/24 h per nanogram per milliliter in women. These sex differences were more marked under conditions of high urinary sodium or urea excretions.Conclusions There was a positive association of serum calcium with urinary calcium excretion in women but not men. Vitamin 25(OH)D 3 was associated with urinary calcium excretion in men but not women. These results suggest important sex differences in the hormonal and dietary control of urinary calcium excretion.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Association of Urinary Calcium Excretion with Serum Calcium and Vitamin D Levels

Rathod

Bonny

Guessous

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…It has been mainly studied in patients producing kidney stones but was also found in 20% of osteoporotic women and 10% of the general population (2)(3)(4). Patients with idiopathic hypercalciuria are characterized by high intestinal absorption and low tubular reabsorption of calcium and may have decreased bone mass (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…Defects of calcium reabsorption in both proximal and distal tubules were observed in hypercalciuric patients with or without stones (9,10). Decreased bone mineral density (BMD) may result from the negative balance between urine loss and enteral absorption of calcium (3,4). However, low BMD was associated with high calcium absorption and could be supported by a primary defect of calcium handling in intestinal, bony, and kidney tubular cells (7,11).…”

Section: Introductionmentioning

confidence: 99%

“…However, low BMD was associated with high calcium absorption and could be supported by a primary defect of calcium handling in intestinal, bony, and kidney tubular cells (7,11). Epidemiologic surveys also suggested that high serum levels of 25(OH)D and sodium intake may predispose to hypercalciuria (3,12), whereas serum levels of 1,25-dihydroxyvitamin D [1,25(OH) 2 D] were not found to be increased in hypercalciuric stone formers (HSFs) (13).…”

Section: Introductionmentioning

confidence: 99%

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Intestinal Calcium Absorption among Hypercalciuric Patients with or without Calcium Kidney Stones

Vezzoli

Macrina

Rubinacci

et al. 2016

CJASN

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Background and objectives Idiopathic hypercalciuria is a frequent defect in calcium kidney stone formers that is associated with high intestinal calcium absorption and osteopenia. Characteristics distinguishing hypercalciuric stone formers from hypercalciuric patients without kidney stone history (HNSFs) are unknown and were explored in our study.Design, setting, participants, & measurements We compared 172 hypercalciuric stone formers with 36 HNSFs retrospectively selected from patients referred to outpatient clinics of the San Raffaele Hospital in Milan from 1998 to 2003. Calcium metabolism and lumbar bone mineral density were analyzed in these patients. A strontium oral load test was performed: strontium was measured in 240-minute urine and serum 30, 60, and 240 minutes after strontium ingestion; serum strontium concentration-time curve and renal strontium clearance were evaluated to estimate absorption and excretion of divalent cations.Results Serum strontium concentration-time curve (P,0.001) and strontium clearance (4.961.3 versus 3.562.7 ml/min; P,0.001) were higher in hypercalciuric stone formers than HNSFs, respectively. The serum strontiumtime curve was also higher in hypercalciuric stone formers with low bone mineral density (n=42) than in hypercalciuric stone formers with normal bone mineral density (n=130; P=0.03) and HNSFs with low (n=22; P=0.01) or normal bone mineral density (n=14; P=0.02). Strontium clearance was greater in hypercalciuric stone formers with normal bone mineral density (5.363.4 ml/min) than in hypercalciuric stone formers and HNSFs with low bone mineral density (3.662.5 and 3.162.5 ml/min, respectively; P=0.03). Multivariate regression analyses displayed that strontium absorption at 30 minutes was positively associated calcium excretion (P=0.03) and negatively associated with lumbar bone mineral density z score (P=0.001) in hypercalciuric stone formers; furthermore, hypercalciuric patients in the highest quartile of strontium absorption had increased stone production risk (odds ratio, 5.06; 95% confidence interval, 1.2 to 20.9; P=0.03).Conclusions High calcium absorption in duodenum and jejunum may expose hypercalciuric patients to the risk of stones because of increased postprandial calcium concentrations in urine and tubular fluid. High calcium absorption may identify patients at risk of bone loss among stone formers.

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Renal Tubular Physiology of Calcium Excretion

Friedman¹,

Bushinsky²

2013

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism

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Urinary calcium is a determinant of bone mineral density in elderly men participating in the InCHIANTI study

Abstract: High calcium excretion is associated with a decreased trabecular BMD in elderly men and may predispose men to trabecular bone loss.

Cited by 46 publications

References 38 publications

Association of Urinary Calcium Excretion with Serum Calcium and Vitamin D Levels

Association of Urinary Calcium Excretion with Serum Calcium and Vitamin D Levels

Intestinal Calcium Absorption among Hypercalciuric Patients with or without Calcium Kidney Stones

Renal Tubular Physiology of Calcium Excretion

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