Document Detail


Hypercalciuria associated with high dietary protein intake is not due to acid load.
MedLine Citation:
PMID:  21976719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT AND OBJECTIVE: Dietary intake of animal proteins is associated with an increase in urinary calcium and nephrolithiasis risk. We tested the hypothesis that the acid load imposed by dietary proteins causes this hypercalciuria.
DESIGN AND SETTING: In a short-term crossover metabolic study, an alkali salt was provided with a high-protein diet (HPD) to neutralize the acid load imparted by dietary proteins.
PARTICIPANTS AND INTERVENTIONS: Eleven healthy volunteers were evaluated at the end of each of four phases while consuming metabolic diets with fixed calcium and sodium content. Phases 1 and 3 consisted of a control diet (CD). Phases 2 and 4 consisted of a eucaloric HPD (60 g/d animal proteins added to CD). Along with HPD in phases 2 and 4, subjects ingested 30 mEq twice daily of either potassium citrate (KCitrate, alkaline salt) or potassium chloride (KCl, control neutral salt).
RESULTS: KCitrate completely neutralized the acid load imparted by HPD (based on changes in urine pH and net acid excretion) and increased urinary citrate. Urinary calcium increased during both HPD phases compared with CD but was not significantly different between the HPD + KCl and HPD + KCitrate phases (182 ± 85 vs. 170 ± 85 mg/d; P = 0.28). Increased urinary saturation with respect to calcium oxalate and uric acid with HPD was abrogated by KCitrate.
CONCLUSIONS: This study suggests that, at least in the short-term, mechanism(s) other than acid load account for hypercalciuria induced by HPD. The beneficial effect of KCitrate on nephrolithiasis risk with HPD is through correction of declines in urine pH and citrate.
Authors:
Naim M Maalouf; Orson W Moe; Beverley Adams-Huet; Khashayar Sakhaee
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-10-05
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  96     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-06     Completed Date:  2012-02-09     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3733-40     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine and Charles, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-8885, USA. Naim.Maalouf@utsouthwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone and Bones / metabolism
Calcium / metabolism*
Cross-Over Studies
Diet
Dietary Proteins / administration & dosage,  adverse effects*
Female
Humans
Hypercalciuria / metabolism*
Male
Middle Aged
Nephrolithiasis / metabolism
Potassium Citrate / pharmacology
Grant Support
ID/Acronym/Agency:
K23-RR21710/RR/NCRR NIH HHS; M01-RR-00633/RR/NCRR NIH HHS; R01 DK081423/DK/NIDDK NIH HHS; R01DK081523/DK/NIDDK NIH HHS; UL1-RR024982/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Dietary Proteins; 6100-05-6/Potassium Citrate; 7440-70-2/Calcium
Comments/Corrections
Comment In:
J Urol. 2012 May;187(5):1928-9   [PMID:  22494767 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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