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Acute oral calcium-sodium citrate load in healthy males. Effects on acid-base and mineral metabolism, oxalate and other risk factors of stone formation in urine.

Abstract

The currently preferred calcium preparations for supplementation of food vary widely with respect to calcium availability, effects on systemic mineral metabolism, acid-base status, and the calciuria-induced risk of urinary tract stone formation. In eight healthy males we studied the response to an acute load with alkali(sodium)-containing soluble calcium citrate (CSC) (molar ratio calcium/sodium/citrate approx. = 1/1/1), when taken in three different doses (10, 20, 30 mmol calcium) together with a continental breakfast. Intestinal calcium absorption, serum calcium, calcitonin, parathyroid hormone (PTH) other markers of bone metabolism, net acid excretion and calcium oxalate crystallization in urine were evaluated. CSC evoked a dose-dependent increase in calcium absorption, calcium in serum and urine, but no overt hypercalcemia, and calciuria was low relative to the excess calcium ingested; PTH fell and calcitonin rose (p < 0.05 vs. breakfast alone), but the diet-independent markers of bone resorption declined only insignificantly, while the markers of bone formation and turnover remained unchanged. There was a significant "once-daily" effect (= cumulative 24 h postload response) of CSC: a decrease in urinary cyclic AMP, phosphorus, and ammonium, and an increase in urinary bicarbonate. Soon after CSC intake, urinary calcium oxalate and hydroxyapatite supersaturation increased dose-dependently, the calcium oxalate crystal diameter was increased, but crystal aggregation time, which is crucial for stone formation, remained statistically unchanged. Thus, CSC provides calcium in a bioavailable form, creates mild systemic alkalinisation and inhibition of bone resorption, but leaves the risk of developing urinary stones unchanged. Comparative long-term studies on bone growth and the maintenance of bone health, using alkali-containing versus alkali-free calcium citrate, appear worthwhile.

Authors+Show Affiliations

,

Department of Surgery, University of Erlangen, Germany.

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Source

MeSH

Administration, Oral
Adult
Antioxidants
Biological Availability
Bone and Bones
Calcium Citrate
Calcium Oxalate
Crystallization
Dietary Supplements
Humans
Hydrogen-Ion Concentration
Intestinal Absorption
Male
Minerals
Postprandial Period
Risk Factors

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9385591

Citation

Schwille, P O., et al. "Acute Oral Calcium-sodium Citrate Load in Healthy Males. Effects On Acid-base and Mineral Metabolism, Oxalate and Other Risk Factors of Stone Formation in Urine." Methods and Findings in Experimental and Clinical Pharmacology, vol. 19, no. 6, 1997, pp. 417-27.
Schwille PO, Schmiedl A, Herrmann U, et al. Acute oral calcium-sodium citrate load in healthy males. Effects on acid-base and mineral metabolism, oxalate and other risk factors of stone formation in urine. Methods Find Exp Clin Pharmacol. 1997;19(6):417-27.
Schwille, P. O., Schmiedl, A., Herrmann, U., Schwille, R., Fink, E., & Manoharan, M. (1997). Acute oral calcium-sodium citrate load in healthy males. Effects on acid-base and mineral metabolism, oxalate and other risk factors of stone formation in urine. Methods and Findings in Experimental and Clinical Pharmacology, 19(6), pp. 417-27.
Schwille PO, et al. Acute Oral Calcium-sodium Citrate Load in Healthy Males. Effects On Acid-base and Mineral Metabolism, Oxalate and Other Risk Factors of Stone Formation in Urine. Methods Find Exp Clin Pharmacol. 1997;19(6):417-27. PubMed PMID: 9385591.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute oral calcium-sodium citrate load in healthy males. Effects on acid-base and mineral metabolism, oxalate and other risk factors of stone formation in urine. AU - Schwille,P O, AU - Schmiedl,A, AU - Herrmann,U, AU - Schwille,R, AU - Fink,E, AU - Manoharan,M, PY - 1997/7/1/pubmed PY - 1997/12/31/medline PY - 1997/7/1/entrez SP - 417 EP - 27 JF - Methods and findings in experimental and clinical pharmacology JO - Methods Find Exp Clin Pharmacol VL - 19 IS - 6 N2 - The currently preferred calcium preparations for supplementation of food vary widely with respect to calcium availability, effects on systemic mineral metabolism, acid-base status, and the calciuria-induced risk of urinary tract stone formation. In eight healthy males we studied the response to an acute load with alkali(sodium)-containing soluble calcium citrate (CSC) (molar ratio calcium/sodium/citrate approx. = 1/1/1), when taken in three different doses (10, 20, 30 mmol calcium) together with a continental breakfast. Intestinal calcium absorption, serum calcium, calcitonin, parathyroid hormone (PTH) other markers of bone metabolism, net acid excretion and calcium oxalate crystallization in urine were evaluated. CSC evoked a dose-dependent increase in calcium absorption, calcium in serum and urine, but no overt hypercalcemia, and calciuria was low relative to the excess calcium ingested; PTH fell and calcitonin rose (p < 0.05 vs. breakfast alone), but the diet-independent markers of bone resorption declined only insignificantly, while the markers of bone formation and turnover remained unchanged. There was a significant "once-daily" effect (= cumulative 24 h postload response) of CSC: a decrease in urinary cyclic AMP, phosphorus, and ammonium, and an increase in urinary bicarbonate. Soon after CSC intake, urinary calcium oxalate and hydroxyapatite supersaturation increased dose-dependently, the calcium oxalate crystal diameter was increased, but crystal aggregation time, which is crucial for stone formation, remained statistically unchanged. Thus, CSC provides calcium in a bioavailable form, creates mild systemic alkalinisation and inhibition of bone resorption, but leaves the risk of developing urinary stones unchanged. Comparative long-term studies on bone growth and the maintenance of bone health, using alkali-containing versus alkali-free calcium citrate, appear worthwhile. SN - 0379-0355 UR - https://www.unboundmedicine.com/medline/citation/9385591/Acute_oral_calcium_sodium_citrate_load_in_healthy_males__Effects_on_acid_base_and_mineral_metabolism_oxalate_and_other_risk_factors_of_stone_formation_in_urine_ L2 - https://medlineplus.gov/minerals.html DB - PRIME DP - Unbound Medicine ER -