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Titolo:
Risk of calcium oxalate nephrolithiasis after calcium or combined calcium and calcitriol supplementation in postmenopausal women
Autore:
Domrongkitchaiporn, S; Ongphiphadhanakul, B; Stitchantrakul, W; Piaseu, N; Chansirikarn, S; Puavilai, G; Rajatanavin, R;
Indirizzi:
Mahidol Univ, Ramathibodi Hosp, Dept Med, Bangkok 10400, Thailand Mahidol Univ Bangkok Thailand 10400 p, Dept Med, Bangkok 10400, Thailand
Titolo Testata:
OSTEOPOROSIS INTERNATIONAL
fascicolo: 6, volume: 11, anno: 2000,
pagine: 486 - 492
SICI:
0937-941X(2000)11:6<486:ROCONA>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
URINARY CITRATE EXCRETION; RENAL STONE FORMERS; DIETARY CALCIUM; MILD HYPEROXALURIA; ELDERLY WOMEN; KIDNEY-STONES; CRYSTALLIZATION; OSTEOPOROSIS; ABSORPTION; FRACTURES;
Keywords:
calcium oxalate; calcium supplement; calcitriol; osteoporosis; supersaturation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Domrongkitchaiporn, S Mahidol Univ, Ramathibodi Hosp, Dept Med, Rama 6, Bangkok 10400, Thailand Mahidol Univ Rama 6 Bangkok Thailand 10400 Thailand
Citazione:
S. Domrongkitchaiporn et al., "Risk of calcium oxalate nephrolithiasis after calcium or combined calcium and calcitriol supplementation in postmenopausal women", OSTEOPOR IN, 11(6), 2000, pp. 486-492

Abstract

Although calcium supplementation can cause hypercalciuria, the risk of nephrolithiasis has been shown to decrease rather than increase among subjectswho had a higher calcium intake. Hypercalciuria is also a well-establishedside effect of calcitriol administration. However, the risk of nephrolithiasis is not well defined. The present study was undertaken to prospectivelydetermine the effect of calcium with or without calcitriol on physicochemical risk factors associated with calcium oxalate nephrolithiasis in Thai postmenopausal women with osteoporosis. Subjects consisted of 53 Thai women more than 10 years postmenopausal who were randomly allocated to receive 750mg of calcium carbonate supplement alone (n = 28) or 750 mg of calcium carbonate plus 0.5 mu g calcitriol (n = 25) daily. Mean+/-SEM for age was 65.3+/- 1.1 years, body weight 53.5 +/- 1.3 kg. Urine samples for biochemical assays were collected at baseline and 3 months after treatment. Supersaturation for calcium oxalate stone formation was assessed from the 24 h urine constituents by the Tiselius's index, AP(CaOx). Three months of calcium supplement alone resulted in a modest, but not significant, increase in urinarycalcium (baseline, 2.90+/-0.33 mmol/day; after treatment 3.58 +/- 0.54 mmol/day) with no change in urinary oxalate, citrate or magnesium. In contrast, calcium together with calcitriol caused a significant increase in urinarycalcium (baseline, 2.87+/-0.41 mmol/day; after treatment, 4.08 +/- 0.57 mmol/day; p < 0.05). No significant change in other urine constituents after treatment with calcium and calcitriol was detected. Therefore, AP(CaOx) didnot significantly increase either after calcium alone (baseline, 1.17+/-0.39; after treatment, 1.36+/-0.28) or after calcium plus calcitriol (baseline, 1.09+/-0.17; after treatment, 1.09+/-0.19). However, after treatments, 12 subjects (23%)- 6 receiving calcium supplement alone and 6 receiving calcium plus calcitriol supplement - had high AP(CaOx) values (greater than theupper limit of 95% CI for AP(CaOx) derived from non-stone-forming Thai women). The post-treatment/baseline ratio was 3.21+/-0.74 for urinary calcium,1.01+/-0.19 for urinary oxalate, and 2.23+/-0.42 (median 1.15) for AP(CaOx). The post-treatment/baseline ratio of calcium, but not for urinary oxalate, had a significant correlation with the post-treatment/baseline ratio of AP(CaOx). Our findings suggest that the alteration in the risk of calcium oxalate nephrolithiasis based on urinary composition is related to the alteration ill urinary calcium. The risk of calcium oxalate nephrolithiasis doesnot increase significantly after calcium or combined calcium and calcitriol supplement in the majority of postmenopausal women with osteoporosis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 13:47:41