POTASSIUM ADMINISTRATION INCREASES AND POTASSIUM DEPRIVATION REDUCES URINARY CALCIUM EXCRETION IN HEALTHY-ADULTS

This study was undertaken to evaluate the effects of dietary K intake, independent of whether the accompanying anion is Cl- or HCO3-, on urinary Ca excretion in healthy adults. The effects of KCl, KHCO3, NaCl and NaHCO3 supplements, 90 mmol/day for four days, were compared in ten subjects fed normal constant diets. Using synthetic diets, the effects of dietary KCl-deprivation for five days followed by recovery were assessed in four subjects and of KHCO3-deprivation for five days followed by recovery were assessed in four subjects. On the fourth day of salt administration, daily urinary Ca excretion and fasting U(Ca)V/GFR were lower during the administration of KCl than during NaCl supplements (DELTA = -1.11 +/- 0.28 SEM mmol/day; P < 0.005 and -0.0077 +/- 0.0022 mmol/liter GFR; P < 0.01), and lower during KHCO3 than during control (-1.26 +/- 0.29 mmol/day; P < 0.005 and -0.0069 +/- 0.0019 mmol/liter GFR; P = 0.005). Both dietary KCl and KHCO3 deprivation (mean reduction in dietary K intake -67 +/- 8 mmol/day) were accompanied by an increase in daily urinary Ca excretion and fasting U(Ca)V/GFR that averaged on the fifth day + 1.31 +/- 0.25 mmol/day (P < 0.005) and + 0.0069 +/- 0.0012 mmol/liter GFR (P < 0.005) above control. Both daily urinary Ca excretion and fasting U(Ca)V/GFR returned toward or to control at the end of recovery. These observations indicate that: 1) KHCO3 decrease fasting and 24-hour urinary Ca excretion; 2) KCl nor NaHCO3, unlike NaCl, do not increase fasting or 24-hour Ca excretion and 3) K deprivation increases both fasting and 24-hour urinary Ca excretion whether the accompanying anion is Cl- or HCO3-. The mechanisms for this effect of K may be mediated by: 1) alterations in ECF volume, since transient increases in urinary Na and Cl excretion and weight loss accompanied KCl or KHCO3 administration, while persistent reductions in urinary Na and Cl excretion and a trend for weight gain accompanied K deprivation; 2) K mediated alterations in renal tubular phosphate transport and renal synthesis of 1,25-(OH)2-vitamin D, since KCl or KHCO3 administration tended to be accompanied by a rise in fasting serum PO4 and TmPO4 and a fall in fasting U(PO4)V/GFR, a fall in serum 1,25-(OH)2-D and a decrease in fasting U(Ca)V/GFR, while dietary KCl or KHCO3 deprivation were accompanied by a reverse sequence.