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Effect of acute acid loading on acid-base and calcium metabolism.
Scand J Urol Nephrol. 2006; 40(1):35-44.SJ

Abstract

OBJECTIVE

To investigate the acid-base and calcium metabolic responses to acute non-carbonic acid loading in idiopathic calcium stone-formers and healthy males using a quantitative organ physiological approach.

MATERIAL AND METHODS

Five-h ammonium chloride loading studies were performed in 12 male recurrent idiopathic calcium stone-formers and 12 matched healthy men using a randomized, placebo-controlled, cross-over design. Arterialized capillary blood, serum and urine were collected hourly for measurement of electrolytes, ionized calcium, magnesium, phosphate, parathyroid hormone and acid-base status. Concentrations of non-metabolizable base (NB) and acid (NA) were calculated from measured concentrations of non-metabolizable ions.

RESULTS

The extracellular acid-base status in the stone-formers during basal conditions and acid loading was comparable to the levels in the healthy controls. The stone-formers tended to have lower renal excretion rates of NA during acid loading; however, for a given degree of non-carbonic acidosis, controls and stone-formers excreted approximately the same amount of NA in the urine, suggesting that the capacity of tubular regeneration of NB was comparable in the two groups. Acid loading resulted in significantly increased concentrations of ionized calcium in serum in both controls and stone-formers. The increase in serum ionized calcium in response to acid loading was, however, significantly higher in the calcium stone-formers than in the healthy individuals. Acid loading resulted in massive calciuria in both groups, with significantly higher urinary calcium excretion rates in the stone-formers compared to the healthy subjects. Renal excretion rates of NA correlated significantly with renal calcium excretion rates in both groups. However, the stone-formers excreted significantly more calcium in the urine at a given rate of renal NA excretion.

CONCLUSIONS

The hypercalciuric and hypercalcaemic responses to loading with non-carbonic acid are more pronounced in recurrent idiopathic calcium stone-formers than in healthy individuals. Acid loading (i.e. protein ingestion) may contribute to disturbed bone metabolism in idiopathic calcium nephrolithiasis as well as calcium stone formation.

Authors+Show Affiliations

Department of Urology, Centre for Kidney Stones and Endourology, Fredericia and Kolding Hospitals, Fredericia, Denmark. palle.osther@dadlnet.dk

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16452054

Citation

Osther, Palle J.. "Effect of Acute Acid Loading On Acid-base and Calcium Metabolism." Scandinavian Journal of Urology and Nephrology, vol. 40, no. 1, 2006, pp. 35-44.
Osther PJ. Effect of acute acid loading on acid-base and calcium metabolism. Scand J Urol Nephrol. 2006;40(1):35-44.
Osther, P. J. (2006). Effect of acute acid loading on acid-base and calcium metabolism. Scandinavian Journal of Urology and Nephrology, 40(1), 35-44.
Osther PJ. Effect of Acute Acid Loading On Acid-base and Calcium Metabolism. Scand J Urol Nephrol. 2006;40(1):35-44. PubMed PMID: 16452054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of acute acid loading on acid-base and calcium metabolism. A1 - Osther,Palle J, PY - 2006/2/3/pubmed PY - 2006/6/9/medline PY - 2006/2/3/entrez SP - 35 EP - 44 JF - Scandinavian journal of urology and nephrology JO - Scand J Urol Nephrol VL - 40 IS - 1 N2 - OBJECTIVE: To investigate the acid-base and calcium metabolic responses to acute non-carbonic acid loading in idiopathic calcium stone-formers and healthy males using a quantitative organ physiological approach. MATERIAL AND METHODS: Five-h ammonium chloride loading studies were performed in 12 male recurrent idiopathic calcium stone-formers and 12 matched healthy men using a randomized, placebo-controlled, cross-over design. Arterialized capillary blood, serum and urine were collected hourly for measurement of electrolytes, ionized calcium, magnesium, phosphate, parathyroid hormone and acid-base status. Concentrations of non-metabolizable base (NB) and acid (NA) were calculated from measured concentrations of non-metabolizable ions. RESULTS: The extracellular acid-base status in the stone-formers during basal conditions and acid loading was comparable to the levels in the healthy controls. The stone-formers tended to have lower renal excretion rates of NA during acid loading; however, for a given degree of non-carbonic acidosis, controls and stone-formers excreted approximately the same amount of NA in the urine, suggesting that the capacity of tubular regeneration of NB was comparable in the two groups. Acid loading resulted in significantly increased concentrations of ionized calcium in serum in both controls and stone-formers. The increase in serum ionized calcium in response to acid loading was, however, significantly higher in the calcium stone-formers than in the healthy individuals. Acid loading resulted in massive calciuria in both groups, with significantly higher urinary calcium excretion rates in the stone-formers compared to the healthy subjects. Renal excretion rates of NA correlated significantly with renal calcium excretion rates in both groups. However, the stone-formers excreted significantly more calcium in the urine at a given rate of renal NA excretion. CONCLUSIONS: The hypercalciuric and hypercalcaemic responses to loading with non-carbonic acid are more pronounced in recurrent idiopathic calcium stone-formers than in healthy individuals. Acid loading (i.e. protein ingestion) may contribute to disturbed bone metabolism in idiopathic calcium nephrolithiasis as well as calcium stone formation. SN - 0036-5599 UR - https://www.unboundmedicine.com/medline/citation/16452054/Effect_of_acute_acid_loading_on_acid_base_and_calcium_metabolism_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365590500368344 DB - PRIME DP - Unbound Medicine ER -