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Arnaud Chiolero - One of the best experts on this subject based on the ideXlab platform.
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Spot urine samples to estimate 24-hour urinary Calcium Excretion in school-age children
European Journal of Pediatrics, 2020Co-Authors: Yan Paccaud, Magali Rios-leyvraz, Murielle Bochud, René Tabin, Bernard Genin, Michel Russo, Michel F Rossier, Pascal Bovet, Arnaud Chiolero, Paloma ParvexAbstract:Urinary Calcium/creatinine ratio (UCa/Cr) on a single spot urine sample is frequently used in children to evaluate calciuria, but its accuracy to estimate 24-h urinary Calcium Excretion (24hUCa) has not been properly assessed. We analyzed the correlation between UCa/Cr in various spot samples and 24hUCa among healthy children. A 24-h urine specimen and three spot urine samples (evening, first, and second morning) were collected in a convenience sample of children aged 6 to 16 years ( n = 101). Measured 24hUCa was compared with UCa/Cr in each of the three spot samples. The ability of UCa/Cr to discriminate between children with and without hypercalciuria (calciuria > 4 mg/kg/24 h, 1 mmol/kg/24 h) and optimal timing of the spot sample were determined. Eighty-five children completed an adequate 24-h urine collection. Pearson correlation coefficients between the UCa/Cr on the spot sample and 24hUCa were 0.64, 0.71, and 0.52 for the evening, first, and second morning spot samples, respectively. Areas under the ROC curve were 0.90, 0.82, and 0.75, respectively, for the corresponding spot samples. Conclusion : The relatively strong correlation between 24hUCa and UCa/Cr in evening and first morning spot urine samples suggests that these spots could be preferred in clinical practice. Trial registration: ClinicalTrials.gov , NCT02900261, date of trial registration 14 September 2016. What is Known: •Urinary Calcium/creatinine ratio on a single spot urine sample is frequently used as a proxy for 24-h urinary Calcium Excretion. •Correlation of these indicators, including the best timing for spot urine sampling, has not been properly assessed. What is New: •Relatively strong correlations were found between the Calcium/creatinine ratio on a single spot urine sample and 24-h urinary Calcium Excretion in healthy children. •Evening and first morning spot samples had the highest correlation.
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spot urine samples to estimate 24 hour urinary Calcium Excretion in school age children
European Journal of Pediatrics, 2020Co-Authors: Yan Paccaud, Murielle Bochud, René Tabin, Bernard Genin, Michel Russo, Michel F Rossier, Pascal Bovet, Arnaud Chiolero, Magali RiosleyvrazAbstract:Urinary Calcium/creatinine ratio (UCa/Cr) on a single spot urine sample is frequently used in children to evaluate calciuria, but its accuracy to estimate 24-h urinary Calcium Excretion (24hUCa) has not been properly assessed. We analyzed the correlation between UCa/Cr in various spot samples and 24hUCa among healthy children. A 24-h urine specimen and three spot urine samples (evening, first, and second morning) were collected in a convenience sample of children aged 6 to 16 years (n = 101). Measured 24hUCa was compared with UCa/Cr in each of the three spot samples. The ability of UCa/Cr to discriminate between children with and without hypercalciuria (calciuria > 4 mg/kg/24 h, 1 mmol/kg/24 h) and optimal timing of the spot sample were determined. Eighty-five children completed an adequate 24-h urine collection. Pearson correlation coefficients between the UCa/Cr on the spot sample and 24hUCa were 0.64, 0.71, and 0.52 for the evening, first, and second morning spot samples, respectively. Areas under the ROC curve were 0.90, 0.82, and 0.75, respectively, for the corresponding spot samples. Conclusion: The relatively strong correlation between 24hUCa and UCa/Cr in evening and first morning spot urine samples suggests that these spots could be preferred in clinical practice. Trial registration: ClinicalTrials.gov , NCT02900261, date of trial registration 14 September 2016.
Bess Dawsonhughes - One of the best experts on this subject based on the ideXlab platform.
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association of urinary citrate with acid base status bone resorption and Calcium Excretion in older men and women
The Journal of Clinical Endocrinology and Metabolism, 2018Co-Authors: Kyla M Shea, Bess DawsonhughesAbstract:Context Elevated urine net acid Excretion (NAE), indicative of subclinical metabolic acidosis, has been associated with higher bone turnover. Urine citrate, which is a common clinical measure, changes in response to acid-base status but its association with bone turnover is uncertain. Objective We evaluated the association between change in urine citrate and change in bone turnover and Calcium Excretion. Design, Intervention, and Participants A total of 233 healthy men and women ≥60 years old were randomly assigned to 1.0 mmol/kg/d potassium bicarbonate (KHCO3), 1.5 mmol/kg/d KHCO3, or placebo for 84 days. Outcome Measures Urine citrate, NAE, N-telopeptide of collagen type-I (NTX), Calcium Excretion, and serum amino-terminal propeptide of type 1 procollagen (P1NP) were measured before and after intervention. Results Urine citrate increased dose dependently after KHCO3 supplementation (P trend < 0.001). The urine citrate change was significantly inversely associated with P1NP change (P = 0.021) but not with change in NTX (P = 0.051) or Calcium Excretion (P = 0.652). The NAE change was positively associated with change in NTX and Calcium Excretion (P ≤ 0.003) but not with change in P1NP (P = 0.051). When the urine citrate change and NAE change were included in the same model, the urine citrate change was not associated with change in NTX, Calcium Excretion, or serum P1NP (P ≥ 0.086), whereas change in NAE remained associated with change in NTX and Calcium Excretion (P ≤ 0.003). Conclusion Urine citrate may not be a suitable alternative to NAE when assessing acid-base status in relation to bone turnover in older adults.
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potassium bicarbonate supplementation lowers bone turnover and Calcium Excretion in older men and women a randomized dose finding trial
Journal of Bone and Mineral Research, 2015Co-Authors: Bess Dawsonhughes, Susan S Harris, Nancy J Palermo, Cheryl H Gilhooly, Kyla M Shea, Roger A Fielding, Lisa CegliaAbstract:The acid load accompanying modern diets may have adverse effects on bone and muscle metabolism. Treatment with alkaline salts of potassium can neutralize the acid load, but the optimal amount of alkali is not established. Our objective was to determine the effectiveness of two doses of potassium bicarbonate (KHCO3) compared with placebo on biochemical markers of bone turnover, and Calcium and nitrogen (N) Excretion. In this double-blind, randomized, placebo-controlled study, 244 men and women age 50 years and older were randomized to placebo or 1 mmol/kg or 1.5 mmol/kg of KHCO3 daily for 3 months; 233 completed the study. The primary outcomes were changes in 24-hour urinary N-telopeptide (NTX) and N; changes in these measures were compared across the treatment groups. Exploratory outcomes included 24-hour urinary Calcium Excretion, serum amino-terminal propeptide of type I procollagen (P1NP), and muscle strength and function assessments. The median administered doses in the low-dose and high-dose groups were 81 mmol/day and 122 mmol/day, respectively. When compared with placebo, urinary NTX declined significantly in the low-dose group (p = 0.012, after adjustment for baseline NTX, gender, and change in urine creatinine) and serum P1NP declined significantly in the low-dose group (p = 0.004, adjusted for baseline P1NP and gender). Urinary Calcium declined significantly in both KHCO3 groups versus placebo (p < 0.001, adjusted for baseline urinary Calcium, gender, and changes in urine creatinine and Calcium intake). There was no significant effect of either dose of KHCO3 on urinary N Excretion or on the physical strength and function measures. KHCO3 has favorable effects on bone turnover and Calcium Excretion and the lower dose appears to be the more effective dose. Long-term trials to assess the effect of alkali on bone mass and fracture risk are needed. © 2015 American Society for Bone and Mineral Research.
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potassium bicarbonate supplementation lowers bone turnover and Calcium Excretion in older men and women a randomized dose finding trial
Journal of Bone and Mineral Research, 2015Co-Authors: Bess Dawsonhughes, Susan S Harris, Nancy J Palermo, Cheryl H Gilhooly, Kyla M Shea, Roger A Fielding, Lisa CegliaAbstract:The acid load accompanying modern diets may have adverse effects on bone and muscle metabolism. Treatment with alkaline salts of potassium can neutralize the acid load, but the optimal amount of alkali is not established. Our objective was to determine the effectiveness of two doses of potassium bicarbonate (KHCO3) compared with placebo on biochemical markers of bone turnover, and Calcium and nitrogen (N) Excretion. In this double-blind, randomized, placebo-controlled study, 244 men and women age 50 years and older were randomized to placebo or 1 mmol/kg or 1.5 mmol/kg of KHCO3 daily for 3 months; 233 completed the study. The primary outcomes were changes in 24-hour urinary N-telopeptide (NTX) and N; changes in these measures were compared across the treatment groups. Exploratory outcomes included 24-hour urinary Calcium Excretion, serum amino-terminal propeptide of type I procollagen (P1NP), and muscle strength and function assessments. The median administered doses in the low-dose and high-dose groups were 81 mmol/day and 122 mmol/day, respectively. When compared with placebo, urinary NTX declined significantly in the low-dose group (p = 0.012, after adjustment for baseline NTX, gender, and change in urine creatinine) and serum P1NP declined significantly in the low-dose group (p = 0.004, adjusted for baseline P1NP and gender). Urinary Calcium declined significantly in both KHCO3 groups versus placebo (p < 0.001, adjusted for baseline urinary Calcium, gender, and changes in urine creatinine and Calcium intake). There was no significant effect of either dose of KHCO3 on urinary N Excretion or on the physical strength and function measures. KHCO3 has favorable effects on bone turnover and Calcium Excretion and the lower dose appears to be the more effective dose. Long-term trials to assess the effect of alkali on bone mass and fracture risk are needed. © 2015 American Society for Bone and Mineral Research.
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treatment with potassium bicarbonate lowers Calcium Excretion and bone resorption in older men and women
The Journal of Clinical Endocrinology and Metabolism, 2009Co-Authors: Bess Dawsonhughes, Susan S Harris, Nancy J Palermo, Carmen Castanedasceppa, Helen Rasmussen, Gerard E DallalAbstract:CONTEXT: Bicarbonate has been implicated in bone health in older subjects on acid-producing diets in short-term studies. OBJECTIVE: The objective of this study was to determine the effects of potassium bicarbonate and its components on changes in bone resorption and Calcium Excretion over 3 months in older men and women. DESIGN, PARTICIPANTS, AND INTERVENTION: In this double-blind, controlled trial, 171 men and women age 50 and older were randomized to receive placebo or 67.5 mmol/d of potassium bicarbonate, sodium bicarbonate, or potassium chloride for 3 months. All subjects received Calcium (600 mg of Calcium as triphosphate) and 525 IU of vitamin D(3) daily. MAIN OUTCOME MEASURES: Twenty-four-hour urinary N-telopeptide and Calcium were measured at entry and after 3 months. Changes in these measures were compared across treatment groups in the 162 participants included in the analyses. RESULTS: Bicarbonate affected the study outcomes, whereas potassium did not; the two bicarbonate groups and the two no bicarbonate groups were therefore combined. Subjects taking bicarbonate had significant reductions in urinary N-telopeptide and Calcium Excretion, when compared with subjects taking no bicarbonate (both before and after adjustment for baseline laboratory value, sex, and changes in urinary sodium and potassium; P = 0.001 for both, adjusted). Potassium supplementation did not significantly affect N-telopeptide or Calcium Excretion. CONCLUSIONS: Bicarbonate, but not potassium, had a favorable effect on bone resorption and Calcium Excretion. This suggests that increasing the alkali content of the diet may attenuate bone loss in healthy older adults.
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treatment with potassium bicarbonate lowers Calcium Excretion and bone resorption in older men and women
The Journal of Clinical Endocrinology and Metabolism, 2009Co-Authors: Bess Dawsonhughes, Susan S Harris, Nancy J Palermo, Carmen Castanedasceppa, Helen Rasmussen, Gerard E DallalAbstract:Context: Bicarbonate has been implicated in bone health in older subjects on acid-producing diets in short-term studies. Objective: The objective of this study was to determine the effects of potassium bicarbonate and its components on changes in bone resorption and Calcium Excretion over 3 months in older men and women. Design, Participants, and Intervention: In this double-blind, controlled trial, 171 men and women age 50 and older were randomized to receive placebo or 67.5 mmol/d of potassium bicarbonate, sodium bicarbonate, or potassium chloride for 3 months. All subjects received Calcium (600 mg of Calcium as triphosphate) and 525 IU of vitamin D3 daily. Main Outcome Measures: Twenty-four-hour urinary N-telopeptide and Calcium were measured at entry and after 3 months. Changes in these measures were compared across treatment groups in the 162 participants included in the analyses. Results: Bicarbonate affected the study outcomes, whereas potassium did not; the two bicarbonate groups and the two no bi...
Gerard E Dallal - One of the best experts on this subject based on the ideXlab platform.
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treatment with potassium bicarbonate lowers Calcium Excretion and bone resorption in older men and women
The Journal of Clinical Endocrinology and Metabolism, 2009Co-Authors: Bess Dawsonhughes, Susan S Harris, Nancy J Palermo, Carmen Castanedasceppa, Helen Rasmussen, Gerard E DallalAbstract:CONTEXT: Bicarbonate has been implicated in bone health in older subjects on acid-producing diets in short-term studies. OBJECTIVE: The objective of this study was to determine the effects of potassium bicarbonate and its components on changes in bone resorption and Calcium Excretion over 3 months in older men and women. DESIGN, PARTICIPANTS, AND INTERVENTION: In this double-blind, controlled trial, 171 men and women age 50 and older were randomized to receive placebo or 67.5 mmol/d of potassium bicarbonate, sodium bicarbonate, or potassium chloride for 3 months. All subjects received Calcium (600 mg of Calcium as triphosphate) and 525 IU of vitamin D(3) daily. MAIN OUTCOME MEASURES: Twenty-four-hour urinary N-telopeptide and Calcium were measured at entry and after 3 months. Changes in these measures were compared across treatment groups in the 162 participants included in the analyses. RESULTS: Bicarbonate affected the study outcomes, whereas potassium did not; the two bicarbonate groups and the two no bicarbonate groups were therefore combined. Subjects taking bicarbonate had significant reductions in urinary N-telopeptide and Calcium Excretion, when compared with subjects taking no bicarbonate (both before and after adjustment for baseline laboratory value, sex, and changes in urinary sodium and potassium; P = 0.001 for both, adjusted). Potassium supplementation did not significantly affect N-telopeptide or Calcium Excretion. CONCLUSIONS: Bicarbonate, but not potassium, had a favorable effect on bone resorption and Calcium Excretion. This suggests that increasing the alkali content of the diet may attenuate bone loss in healthy older adults.
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treatment with potassium bicarbonate lowers Calcium Excretion and bone resorption in older men and women
The Journal of Clinical Endocrinology and Metabolism, 2009Co-Authors: Bess Dawsonhughes, Susan S Harris, Nancy J Palermo, Carmen Castanedasceppa, Helen Rasmussen, Gerard E DallalAbstract:Context: Bicarbonate has been implicated in bone health in older subjects on acid-producing diets in short-term studies. Objective: The objective of this study was to determine the effects of potassium bicarbonate and its components on changes in bone resorption and Calcium Excretion over 3 months in older men and women. Design, Participants, and Intervention: In this double-blind, controlled trial, 171 men and women age 50 and older were randomized to receive placebo or 67.5 mmol/d of potassium bicarbonate, sodium bicarbonate, or potassium chloride for 3 months. All subjects received Calcium (600 mg of Calcium as triphosphate) and 525 IU of vitamin D3 daily. Main Outcome Measures: Twenty-four-hour urinary N-telopeptide and Calcium were measured at entry and after 3 months. Changes in these measures were compared across treatment groups in the 162 participants included in the analyses. Results: Bicarbonate affected the study outcomes, whereas potassium did not; the two bicarbonate groups and the two no bi...
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comparative effects of oral aromatic and branched chain amino acids on urine Calcium Excretion in humans
Osteoporosis International, 2007Co-Authors: Bess Dawsonhughes, Susan S Harris, Helen Rasmussen, Gerard E DallalAbstract:In 30 adults, increasing intake of aromatic amino acids increased Calcium Excretion and serum IGF-1, but not indices of bone turnover, when compared with similar increases in intake of branched-chain amino acids. The mechanisms involved are not certain but these findings suggest a role for the Calcium sensor receptor. In contrast to branched-chain amino acids (BCAAs), aromatic amino acids (AAAs) bind to the Calcium sensing receptor (CaR) and thus have an increased potential to affect Calcium homeostasis. In this study we compare the effects of increased intake of AAAs versus BCAAs on Calcium Excretion, serum IGF-1, markers of bone turnover, and 4-hr Calcium Excretion after an oral Calcium load. After two weeks on low-protein metabolic diets, 30 healthy subjects were randomized to a fivefold increase in intake of AAAs or BCAAs for two weeks. Changes in Calcium Excretion and other measures were compared in the two groups. With the increase in amino acid intake, 24-hr Calcium Excretion (P = 0.027), IGF-1 (P = 0.022), and 4-hr Calcium Excretion after an oral load (P = 0.023) increased significantly in the AAA relative to the BCAA group. Group changes in turnover markers did not differ significantly. In comparison with BCAAs, AAAs promoted Calcium Excretion. The calciuria does not appear to result from increases in bone resorption and may occur by increasing Calcium absorption. The AAAs also increased circulating levels of IGF-1. Collectively these findings raise the possibility that AAAs may selectively influence Calcium homeostasis through their interactions with the CaR.
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effect of dietary protein supplements on Calcium Excretion in healthy older men and women
The Journal of Clinical Endocrinology and Metabolism, 2004Co-Authors: Bess Dawsonhughes, Susan S Harris, Helen Rasmussen, Lingyi Song, Gerard E DallalAbstract:Currently there is no consensus on the impact of dietary protein on Calcium and bone metabolism. This study was conducted to examine the effect of increasing protein intake on urinary Calcium Excretion and to compare circulating levels of IGF-I and biochemical markers of bone turnover in healthy older men and women who consumed either a high or a low protein food supplement for 9 wk. Thirty-two subjects with usual protein intakes of less than 0.85 g/kg.d were randomly assigned to daily high (0.75 g/kg) or low (0.04 g/kg) protein supplement groups. Isocaloric diets were maintained by advising subjects to reduce their intake of carbohydrates. Selected biochemical measurements were made at baseline and on d 35 and either d 49 or 63. Changes in urinary Calcium Excretion in the two groups did not differ significantly over the course of the study. The high protein group had significantly higher levels of serum IGF-I (P = 0.008) and lower levels of urinary N-telopeptide (P = 0.038) over the period of d 35-49 or 63. We conclude that increasing protein intake from 0.78 to 1.55 g/kg.d with meat supplements in combination with reducing carbohydrate intake did not alter urine Calcium Excretion, but was associated with higher circulating levels of IGF-I, a bone growth factor, and lowered levels of urinary N-telopeptide, a marker of bone resorption. In contrast to the widely held belief that increased protein intake results in Calcium wasting, meat supplements, when exchanged isocalorically for carbohydrates, may have a favorable impact on the skeleton in healthy older men and women.
Yan Paccaud - One of the best experts on this subject based on the ideXlab platform.
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Spot urine samples to estimate 24-hour urinary Calcium Excretion in school-age children
European Journal of Pediatrics, 2020Co-Authors: Yan Paccaud, Magali Rios-leyvraz, Murielle Bochud, René Tabin, Bernard Genin, Michel Russo, Michel F Rossier, Pascal Bovet, Arnaud Chiolero, Paloma ParvexAbstract:Urinary Calcium/creatinine ratio (UCa/Cr) on a single spot urine sample is frequently used in children to evaluate calciuria, but its accuracy to estimate 24-h urinary Calcium Excretion (24hUCa) has not been properly assessed. We analyzed the correlation between UCa/Cr in various spot samples and 24hUCa among healthy children. A 24-h urine specimen and three spot urine samples (evening, first, and second morning) were collected in a convenience sample of children aged 6 to 16 years ( n = 101). Measured 24hUCa was compared with UCa/Cr in each of the three spot samples. The ability of UCa/Cr to discriminate between children with and without hypercalciuria (calciuria > 4 mg/kg/24 h, 1 mmol/kg/24 h) and optimal timing of the spot sample were determined. Eighty-five children completed an adequate 24-h urine collection. Pearson correlation coefficients between the UCa/Cr on the spot sample and 24hUCa were 0.64, 0.71, and 0.52 for the evening, first, and second morning spot samples, respectively. Areas under the ROC curve were 0.90, 0.82, and 0.75, respectively, for the corresponding spot samples. Conclusion : The relatively strong correlation between 24hUCa and UCa/Cr in evening and first morning spot urine samples suggests that these spots could be preferred in clinical practice. Trial registration: ClinicalTrials.gov , NCT02900261, date of trial registration 14 September 2016. What is Known: •Urinary Calcium/creatinine ratio on a single spot urine sample is frequently used as a proxy for 24-h urinary Calcium Excretion. •Correlation of these indicators, including the best timing for spot urine sampling, has not been properly assessed. What is New: •Relatively strong correlations were found between the Calcium/creatinine ratio on a single spot urine sample and 24-h urinary Calcium Excretion in healthy children. •Evening and first morning spot samples had the highest correlation.
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spot urine samples to estimate 24 hour urinary Calcium Excretion in school age children
European Journal of Pediatrics, 2020Co-Authors: Yan Paccaud, Murielle Bochud, René Tabin, Bernard Genin, Michel Russo, Michel F Rossier, Pascal Bovet, Arnaud Chiolero, Magali RiosleyvrazAbstract:Urinary Calcium/creatinine ratio (UCa/Cr) on a single spot urine sample is frequently used in children to evaluate calciuria, but its accuracy to estimate 24-h urinary Calcium Excretion (24hUCa) has not been properly assessed. We analyzed the correlation between UCa/Cr in various spot samples and 24hUCa among healthy children. A 24-h urine specimen and three spot urine samples (evening, first, and second morning) were collected in a convenience sample of children aged 6 to 16 years (n = 101). Measured 24hUCa was compared with UCa/Cr in each of the three spot samples. The ability of UCa/Cr to discriminate between children with and without hypercalciuria (calciuria > 4 mg/kg/24 h, 1 mmol/kg/24 h) and optimal timing of the spot sample were determined. Eighty-five children completed an adequate 24-h urine collection. Pearson correlation coefficients between the UCa/Cr on the spot sample and 24hUCa were 0.64, 0.71, and 0.52 for the evening, first, and second morning spot samples, respectively. Areas under the ROC curve were 0.90, 0.82, and 0.75, respectively, for the corresponding spot samples. Conclusion: The relatively strong correlation between 24hUCa and UCa/Cr in evening and first morning spot urine samples suggests that these spots could be preferred in clinical practice. Trial registration: ClinicalTrials.gov , NCT02900261, date of trial registration 14 September 2016.
Anthony Sebastian - One of the best experts on this subject based on the ideXlab platform.
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POTASSIUM CITRATE PREVENTS INCREASED URINE Calcium Excretion AND BONE RESORPTION INDUCED BY A HIGH SODIUM CHLORIDE DIET
2030 Uzbekistan Research Online, 2019Co-Authors: Deborah Sellmyer, Monique Schloetter, Anthony SebastianAbstract:The amount of sodium chloride in the diet of industrialized nations far exceeds physiological requirements. The impact of abundant ietary salt on skeletal health has yet to be established, but is potentially detrimental through increased urinary Calcium losses. We examined the effect of increased dietary sodium chloride on urine Calcium Excretion and bone turnover markers in postmenopausal women and, further, whether potassium citrate attenuates the effects of increased dietary salt. Postmenopausal women (n _ 60) were adapted to a low-salt (87 mmol/d sodium) diet for 3 wk, then randomized to a high-salt (225 mmol/d sodium) diet plus potassium citrate (90 mmol/d) or a high-salt diet plus placebo for 4 wk. Urine Calcium, urine N-telopeptide, urine cAMP, serum osteocalcin, and fasting serum PTH were measured at the end of the lowand high-salt diets. On the high salt plus placebo diet, urine Calcium increased 42-12 mg/d (mean _ SEM), but decreased 8-14 mg/d in the high salt plus potassium citrate group (P-0.008, potassium citrate vs. placebo, npaired t test). Ntelopeptide increased 6.4-1.4 nanomoles bone collagen equivalents per millimole creatinine in the high salt plus placebo group and 2.0-1.7 nanomoles bone collagen equivalents per millimole creatinine in the high salt plus potassium citrate group (P 0.05, potassium citrate vs. placebo, unpaired t test). Osteocalcin, PTH, and cAMP were not significantly altered. The addition of oral potassium citrate to a high-salt diet prevented the increased Excretion of urine Calcium and the bone resorption marker caused by a high salt intake. Increased intake of dietary sources of potassium alkaline salts, namely fruit and vegetables, may be beneficial for postmenopausal women at risk for osteoporosis, particularly those consuming a diet generous in sodium chloride. (J Clin Endocrinol Metab 87: 2008–2012, 2002
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potassium citrate prevents increased urine Calcium Excretion and bone resorption induced by a high sodium chloride diet
The Journal of Clinical Endocrinology and Metabolism, 2002Co-Authors: Deborah E. Sellmeyer, Monique Schloetter, Anthony SebastianAbstract:The amount of sodium chloride in the diet of industrialized nations far exceeds physiological requirements. The impact of abundant dietary salt on skeletal health has yet to be established, but is potentially detrimental through increased urinary Calcium losses. We examined the effect of increased dietary sodium chloride on urine Calcium Excretion and bone turnover markers in postmenopausal women and, further, whether potassium citrate attenuates the effects of increased dietary salt. Postmenopausal women (n = 60) were adapted to a low-salt (87 mmol/d sodium) diet for 3 wk, then randomized to a high-salt (225 mmol/d sodium) diet plus potassium citrate (90 mmol/d) or a high-salt diet plus placebo for 4 wk. Urine Calcium, urine N-telopeptide, urine cAMP, serum osteocalcin, and fasting serum PTH were measured at the end of the low- and high-salt diets. On the high salt plus placebo diet, urine Calcium increased 42 +/- 12 mg/d (mean +/- SEM), but decreased 8 +/- 14 mg/d in the high salt plus potassium citrate group (P = 0.008, potassium citrate vs. placebo, unpaired t test). N-telopeptide increased 6.4 +/- 1.4 nanomoles bone collagen equivalents per millimole creatinine in the high salt plus placebo group and 2.0 +/- 1.7 nanomoles bone collagen equivalents per millimole creatinine in the high salt plus potassium citrate group (P < 0.05, potassium citrate vs. placebo, unpaired t test). Osteocalcin, PTH, and cAMP were not significantly altered. The addition of oral potassium citrate to a high-salt diet prevented the increased Excretion of urine Calcium and the bone resorption marker caused by a high salt intake. Increased intake of dietary sources of potassium alkaline salts, namely fruit and vegetables, may be beneficial for postmenopausal women at risk for osteoporosis, particularly those consuming a diet generous in sodium chloride.
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comparative effects of potassium chloride and bicarbonate on thiazide induced reduction in urinary Calcium Excretion
Kidney International, 2000Co-Authors: Lynda A Frassetto, Curtis R Morris, Eileen Nash, Anthony SebastianAbstract:Comparative effects of potassium chloride and bicarbonate on thiazide-induced reduction in urinary Calcium Excretion. Background The chronic low-grade metabolic acidosis that occurs in various renal disorders and in normal people, and that is related both to dietary net acid load and age-related renal functional decline, may contribute to osteoporosis by increasing urine Calcium Excretion. Administration of potassium (K) alkali salts neutralizes acid and lowers urine Calcium Excretion. Urine Calcium Excretion also can be reduced by the administration of thiazide diuretics, which are often given with supplemental K to avoid hypokalemia. We determined whether the K alkali salt potassium bicarbonate (KHCO 3 ) and the thiazide diuretic hydrochlorothiazide (HCTZ) combined is more effective in reducing urinary Calcium than KHCO 3 alone or HCTZ combined with the conventionally coadministered nonalkalinizing K salt potassium chloride (KCl). Methods Thirty-one healthy men and women aged 50 or greater were recruited for a four-week, double-blind, randomized study. After a baseline period of 10 days with three 24-hour urine and arterialized blood collections, subjects were randomized to receive either HCTZ (50 mg) plus potassium (60 mmol daily) as either the chloride or bicarbonate salt. Another 19 women received potassium bicarbonate (60 mmol) alone. After two weeks, triplicate collections of 24-hour urines and arterialized bloods were repeated. Results Urinary Calcium Excretion decreased significantly in all groups. KHCO 3 alone and HCTZ + KCl induced similar decreases (-0.70 ± 0.60 vs. -0.80 ± 1.0 mmol/day, respectively). Compared with those treatments, the combination of HCTZ + KHCO 3 induced more than a twofold greater decrease in urinary Calcium Excretion (-1.8 ± 1.2 mmol/day, P 3 and KHCO 3 alone reduced net acid Excretion significantly ( P Conclusions KHCO 3 was superior to KCl as an adjunct to HCTZ, inducing a twofold greater reduction in urine Calcium Excretion, and completely neutralizing endogenous acid production so as to correct the pre-existing mild metabolic acidosis that an acid-producing diet usually induces in older people. Accordingly, for reducing urine Calcium Excretion in stone disease and osteoporosis, the combination of HCTZ + KHCO 3 may be preferable to that of HCTZ + KCl.
