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Calcium metabolism in health and disease.
Clin J Am Soc Nephrol. 2010 Jan; 5 Suppl 1:S23-30.CJ

Abstract

This brief review focuses on calcium balance and homeostasis and their relationship to dietary calcium intake and calcium supplementation in healthy subjects and patients with chronic kidney disease and mineral bone disorders (CKD-MBD). Calcium balance refers to the state of the calcium body stores, primarily in bone, which are largely a function of dietary intake, intestinal absorption, renal excretion, and bone remodeling. Bone calcium balance can be positive, neutral, or negative, depending on a number of factors, including growth, aging, and acquired or inherited disorders. Calcium homeostasis refers to the hormonal regulation of serum ionized calcium by parathyroid hormone, 1,25-dihydroxyvitamin D, and serum ionized calcium itself, which together regulate calcium transport at the gut, kidney, and bone. Hypercalcemia and hypocalcemia indicate serious disruption of calcium homeostasis but do not reflect calcium balance on their own. Calcium balance studies have determined the dietary and supplemental calcium requirements needed to optimize bone mass in healthy subjects. However, similar studies are needed in CKD-MBD, which disrupts both calcium balance and homeostasis, because these data in healthy subjects may not be generalizable to this patient group. Importantly, increasing evidence suggests that calcium supplementation may enhance soft tissue calcification and cardiovascular disease in CKD-MBD. Further research is needed to elucidate the risks and mechanisms of soft tissue calcification with calcium supplementation in both healthy subjects and CKD-MBD patients.

Authors+Show Affiliations

Indiana University Medical School, Indianapolis, Indiana, USA. mpeacock@iupui.edu

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

20089499

Citation

Peacock, Munro. "Calcium Metabolism in Health and Disease." Clinical Journal of the American Society of Nephrology : CJASN, vol. 5 Suppl 1, 2010, pp. S23-30.
Peacock M. Calcium metabolism in health and disease. Clin J Am Soc Nephrol. 2010;5 Suppl 1:S23-30.
Peacock, M. (2010). Calcium metabolism in health and disease. Clinical Journal of the American Society of Nephrology : CJASN, 5 Suppl 1, S23-30. https://doi.org/10.2215/CJN.05910809
Peacock M. Calcium Metabolism in Health and Disease. Clin J Am Soc Nephrol. 2010;5 Suppl 1:S23-30. PubMed PMID: 20089499.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcium metabolism in health and disease. A1 - Peacock,Munro, PY - 2010/1/22/entrez PY - 2010/2/3/pubmed PY - 2010/4/3/medline SP - S23 EP - 30 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 5 Suppl 1 N2 - This brief review focuses on calcium balance and homeostasis and their relationship to dietary calcium intake and calcium supplementation in healthy subjects and patients with chronic kidney disease and mineral bone disorders (CKD-MBD). Calcium balance refers to the state of the calcium body stores, primarily in bone, which are largely a function of dietary intake, intestinal absorption, renal excretion, and bone remodeling. Bone calcium balance can be positive, neutral, or negative, depending on a number of factors, including growth, aging, and acquired or inherited disorders. Calcium homeostasis refers to the hormonal regulation of serum ionized calcium by parathyroid hormone, 1,25-dihydroxyvitamin D, and serum ionized calcium itself, which together regulate calcium transport at the gut, kidney, and bone. Hypercalcemia and hypocalcemia indicate serious disruption of calcium homeostasis but do not reflect calcium balance on their own. Calcium balance studies have determined the dietary and supplemental calcium requirements needed to optimize bone mass in healthy subjects. However, similar studies are needed in CKD-MBD, which disrupts both calcium balance and homeostasis, because these data in healthy subjects may not be generalizable to this patient group. Importantly, increasing evidence suggests that calcium supplementation may enhance soft tissue calcification and cardiovascular disease in CKD-MBD. Further research is needed to elucidate the risks and mechanisms of soft tissue calcification with calcium supplementation in both healthy subjects and CKD-MBD patients. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/20089499/Calcium_metabolism_in_health_and_disease_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=20089499 DB - PRIME DP - Unbound Medicine ER -