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Effect of dietary calcium on stone forming propensity.
J Urol 2003; 169(2):470-4JU

Abstract

PURPOSE

Epidemiological studies have reported that high calcium diet protects against kidney stone formation in normal subjects. This metabolic study was designed to elucidate the physiological and physicochemical effects conferring this apparent protection.

MATERIALS AND METHODS

A total of 21 normal volunteers underwent 2 phases of study in a crossover, randomized design, wherein they consumed constant metabolic diets that matched the estimated highest and lowest quintiles of calcium intake from published epidemiological studies.

RESULTS

Urinary calcium was significantly greater on the high calcium diet (148 +/- 55 versus 118 +/- 43 mg. daily, p <0.01, p <0.01) but urinary oxalate did not differ between diets. There was no difference in relative saturation ratio of calcium oxalate between the 2 diets. The high calcium diet significantly increased saturation of brushite and decreased that of uric acid. Due to the other differences between the diets (more fluid, potassium, magnesium and phosphate in the high calcium diet), the high calcium diet also increased 24-hour urinary volume, potassium, phosphorus, pH and citrate. After adjustment of these confounding variables, the high calcium diet significantly increased relative saturation ratio of calcium oxalate by 24%.

CONCLUSIONS

High calcium diet from published epidemiological studies does not alter the propensity for calcium oxalate crystallization in normal subjects despite increased urinary calcium and unaltered urinary oxalate because of the greater amounts of ingested fluid, potassium and phosphate. However, high calcium intake alone, without concomitant changes in the diet, poses a modest risk for calcium stone formation.

Authors+Show Affiliations

Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-8885, USA.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12544289

Citation

Heller, Howard J., et al. "Effect of Dietary Calcium On Stone Forming Propensity." The Journal of Urology, vol. 169, no. 2, 2003, pp. 470-4.
Heller HJ, Doerner MF, Brinkley LJ, et al. Effect of dietary calcium on stone forming propensity. J Urol. 2003;169(2):470-4.
Heller, H. J., Doerner, M. F., Brinkley, L. J., Adams-Huet, B., & Pak, C. Y. (2003). Effect of dietary calcium on stone forming propensity. The Journal of Urology, 169(2), pp. 470-4.
Heller HJ, et al. Effect of Dietary Calcium On Stone Forming Propensity. J Urol. 2003;169(2):470-4. PubMed PMID: 12544289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of dietary calcium on stone forming propensity. AU - Heller,Howard J, AU - Doerner,Mark F, AU - Brinkley,Linda J, AU - Adams-Huet,Beverley, AU - Pak,Charles Y C, PY - 2003/1/25/pubmed PY - 2003/2/26/medline PY - 2003/1/25/entrez KW - Non-programmatic SP - 470 EP - 4 JF - The Journal of urology JO - J. Urol. VL - 169 IS - 2 N2 - PURPOSE: Epidemiological studies have reported that high calcium diet protects against kidney stone formation in normal subjects. This metabolic study was designed to elucidate the physiological and physicochemical effects conferring this apparent protection. MATERIALS AND METHODS: A total of 21 normal volunteers underwent 2 phases of study in a crossover, randomized design, wherein they consumed constant metabolic diets that matched the estimated highest and lowest quintiles of calcium intake from published epidemiological studies. RESULTS: Urinary calcium was significantly greater on the high calcium diet (148 +/- 55 versus 118 +/- 43 mg. daily, p <0.01, p <0.01) but urinary oxalate did not differ between diets. There was no difference in relative saturation ratio of calcium oxalate between the 2 diets. The high calcium diet significantly increased saturation of brushite and decreased that of uric acid. Due to the other differences between the diets (more fluid, potassium, magnesium and phosphate in the high calcium diet), the high calcium diet also increased 24-hour urinary volume, potassium, phosphorus, pH and citrate. After adjustment of these confounding variables, the high calcium diet significantly increased relative saturation ratio of calcium oxalate by 24%. CONCLUSIONS: High calcium diet from published epidemiological studies does not alter the propensity for calcium oxalate crystallization in normal subjects despite increased urinary calcium and unaltered urinary oxalate because of the greater amounts of ingested fluid, potassium and phosphate. However, high calcium intake alone, without concomitant changes in the diet, poses a modest risk for calcium stone formation. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/12544289/Effect_of_dietary_calcium_on_stone_forming_propensity_ L2 - https://www.jurology.com/doi/full/10.1097/01.ju.0000043669.63989.22?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -