THE IMPORTANCE OF RENAL NET ACID EXCRETION AS A DETERMINANT OF FASTING URINARY CALCIUM EXCRETION

被引:96
作者
LEMANN, J
GRAY, RW
MAIERHOFER, WJ
CHEUNG, HS
机构
[1] MED COLL WISCONSIN, DEPT MED, MILWAUKEE, WI 53226 USA
[2] MED COLL WISCONSIN, DEPT BIOCHEM, MILWAUKEE, WI 53226 USA
[3] MED COLL WISCONSIN, CLIN RES CTR, MILWAUKEE, WI 53226 USA
关键词
D O I
10.1038/ki.1986.60
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
To evaluate the effects of changing rates of fixed acid production on fasting urine Ca/creatinine, we studied five healthy men fed constant diets during control conditions (serum HCO3 27.3 .+-. 2.6 SD mEq/liter and blood H+ 40.4 .+-. 1.5 .mu.Eq/liter) and then during the administration of NH4Cl 3.0 mEq/kg/day (serum HCO3 22.5 .+-. 4.9 mEq/liter; P < 0.025, and H+ 46.8 .+-. 2.3 mEq/liter; P < 0.005). In addition to the expected increase in daily urinary Ca excretion from 5.2 .+-. 2.0 to 12.5 .+-. 3.0 mmole/day; P < 0.001 as daily urinary net acid excretion was increased from 48 .+-. 32 to 257 .+-. 33 mEq/day; P < 0.001 we observed that fasting urinary net acid/creatinine excretion also increased from 2.9 .+-. 1.2 to 11.1 .+-. 1.2 mEq/mmole creatinine; P < 0.001 and fasting urine Ca/creatinine increased from 0.158 .+-. 0.111 to 0.456 .+-. 0.109 mmole/mmole creatinine; P < 0.005. The additional Ca appearing in the urine during acidosis ultimately reflected augmented net bone resorption since daily urinary hydroxyproline excretion was increased from 0.232 .+-. 0.062 to 0.377 .+-. 0.108 mmole/day; P < 0.01. Since variations in diet composition can cause fixed acid production and thus renal net acid excretion to vary from about zero to 200 mEq/day, such a range could cause fasting Ca/creatinine to vary from 0.09 to 0.37 mmole/mmole (0.03 to 0.13 mg/mg) and should be taken into account in the evaluation of fasting Ca/creatinine.
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页码:743 / 746
页数:4
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