scholarly journals Acute effects of calcium citrate with or without a meal, calcium-fortified juice and a dairy product meal on serum calcium and phosphate: a randomised cross-over trial

2015 ◽  
Vol 113 (10) ◽  
pp. 1585-1594 ◽  
Author(s):  
Sarah M. Bristow ◽  
Gregory D. Gamble ◽  
Angela Stewart ◽  
Rama Kalluru ◽  
Anne M. Horne ◽  
...  
Keyword(s):  
Single Dose ◽  
Cardiovascular Risk ◽  
Calcium Phosphate ◽  
Serum Calcium ◽  
Dairy Product ◽  
Serum Phosphate ◽  
Calcium Citrate ◽  
Acute Effects ◽  
Phosphate Product ◽  
Different Sources

Ca supplements, but not dietary Ca, have been associated with increased cardiovascular risk. This difference could be related to differences in their acute effects on serum Ca. We therefore examined the effects of Ca from different sources on serum Ca and phosphate in a randomised, cross-over trial of ten women (mean age of 69 years). Fasting participants received a single dose of 500 mg of Ca as citrate, citrate with a meal, fortified juice or a dairy product meal, with at least 6 d between each intervention. Blood was sampled before and 1, 2, 4 and 6 h after each intervention was ingested. Serum ionised and total Ca increased significantly from baseline over 6 h. Using calcium citrate fasting as a comparator, the elevations in ionised and total Ca were similar after fortified juice, delayed after calcium citrate with a meal and smaller after a dairy product meal. Serum phosphate and calcium–phosphate product increased from baseline after calcium citrate with a meal and after a dairy product meal, and they declined after calcium citrate fasting and after fortified juice. The elevations in serum Ca in the present study were only slightly different from those observed after the administration of 1000 mg of Ca in a previous study. These data indicate that different sources of Ca have different acute effects on serum Ca and support recommendations that dietary Ca might be safer than supplements. Whether these differences contribute to differences in cardiovascular risk requires further study.

scholarly journals Association of Serum Calcium and Phosphate Concentrations with Glucose Metabolism Markers: The Furukawa Nutrition and Health Study

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2344
Author(s):  
Shamima Akter ◽  
Masafumi Eguchi ◽  
Takeshi Kochi ◽  
Isamu Kabe ◽  
Akiko Nanri ◽  
...  
Keyword(s):  
Calcium Phosphate ◽  
Glucose Metabolism ◽  
Serum Calcium ◽  
Serum Phosphate ◽  
Health Study ◽  
Model Assessment ◽  
Adjusted Means ◽  
Homeostatic Model Assessment ◽  
Phosphate Product ◽  
Homeostatic Model

Calcium and phosphate may play an important role in cardio-metabolic abnormalities, including type 2 diabetes; however, epidemiological evidence of the association of calcium and phosphate status with glucose metabolism among Asians is limited. In the current study, we performed a cross-sectional analysis of the association of serum calcium, phosphate, and calcium–phosphate product concentrations with glucose metabolism markers among Japanese individuals. Overall, 1701 workers (aged 18–78 years) who participated in a health survey were enrolled in this study. Multivariable linear regression models were used to estimate means of homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β), and glycated hemoglobin (HbA1c). Serum calcium concentration was positively associated with HOMA-IR and HbA1c (p for trend < 0.01). Multivariable-adjusted means (95% confidence interval (CI)) of HOMA-IR for the lowest and highest quartiles of serum calcium were 0.78 (0.75–0.82) and 1.01 (0.96–1.07), respectively. The corresponding values for HbA1c were 5.24 (5.22–5.27) and 5.29 (5.26–5.32), respectively. Serum phosphate and calcium–phosphate product concentrations were inversely associated with HOMA-IR (p for trend < 0.01). Multivariable-adjusted means (95% CI) of HOMA-IR for the lowest and highest quartiles of serum phosphate were 1.04 (0.99–1.09) and 0.72 (0.69–0.76), respectively. The corresponding values for calcium–phosphate product were 1.04 (0.99–1.09) and 0.73 (0.69–0.77), respectively. The current findings suggest that higher serum calcium and lower serum phosphate concentrations are associated with IR among apparently healthy adults.

PREVENTION OF CUTANEOUS CALCIPHYLAXIS IN CALCIUM-DEFICIENT RATS

1965 ◽  
Vol 43 (2) ◽  
pp. 235-240 ◽  
Author(s):  
Pierre Jean ◽  
Denis Desaulniers
Keyword(s):  
Calcium Phosphate ◽  
Serum Calcium ◽  
Dietary Calcium ◽  
Deficient Diet ◽  
Phosphate Product

Dietary calcium is essential for the production of skin calcification in rats calciphylactically sensitized with dihydrotachysterol (DHT) and challenged with FeCl3 injection, or with the mild trauma of epilation. A calcium-deficient diet delays the rise in serum calcium after the administration of DHT. A comparatively lower calcium–phosphate product at the time of challenge could explain the absence of skin calcification in these animals.

scholarly journals Influence of Serum Biochemistry on Bone and Kidney Phenotypes in Subjects With Symptomatic Primary Hyperparathyroidism

2021 ◽  
Author(s):  
Mainak Banerjee ◽  
Jan Ahamed ◽  
Subhankar Chowdhury ◽  
Satinath Mukhopadhyay
Keyword(s):  
Renal Function ◽  
Calcium Phosphate ◽  
Serum Calcium ◽  
Bone Disease ◽  
Impaired Renal Function ◽  
Serum Biochemistry ◽  
Clinical Fractures ◽  
25 Hydroxy Vitamin D ◽  
Phosphate Product ◽  
Patient Subgroups

Abstract OBJECTIVETo analyze the abnormalities in serum parathormone (PTH)-25-hydroxy-vitamin D (25-OHD) axis and calcium phosphate homeostasis in symptomatic PHPT patients having bone disease, nephrolithiasis and impaired renal function (IRF) at diagnosis. METHODSConsecutive adults (>18 years) with diagnosed symptomatic PHPT were enrolled in the retrospective study. Relevant clinical, biochemical and imaging parameters were recorded.RESULTSAdult patients with symptomatic PHPT were identified (N=60, age 45.2±14.4 years, 45 females). Predominant phenotypes were bone disease (osteoporosis and/or clinical fractures, n=42, 70%) and nephrolithiasis (n=24, 40%). Compared to patients with nephrolithiasis only (subgroup C, n=7) and simultaneous bone disease/nephrolithiasis (subgroup D, n=17), patients with isolated bone disease phenotype (subgroup B, n=25) had significantly higher alkaline phosphatase (AlP) and lower 25-OHD levels at presentation. Patient subgroups with nephrolithiasis had higher serum calcium levels and lower effective glomerular filtration rate (eGFR) at presentation. PTH was not significantly different among these subgroups. Patients with IRF (eGFR <60 ml/min per 1.73 m2, n=17) in our cohort had significantly higher serum calcium, phosphate, PTH levels and nephrolithiasis rates. Presence of nephrolithiasis, higher calcium x phosphate product (IRF: 36.2 ± 10.7 versus no IRF: 26.2 ± 5.7 mg2/dl2) and increased PTH levels were independently associated with IRF at diagnosis.CONCLUSIONSWhile PHPT patients with isolated bone disease were found to have lower 25-OHD and higher AlP levels independent of PTH levels; PTH was found to be an independent predictor of impaired renal function at diagnosis.

scholarly journals Bone metabolic disorder and its contributing factors in patients with chronic kidney disease; a three-year cohort study

2021 ◽  
Vol 11 (1) ◽  
pp. e5-e5
Author(s):  
Kourosh Eftekharian ◽  
Hassan Eftekhar Ardebili ◽  
Mohammad Hossein Shojamoradi ◽  
Sahar Samimi
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Calcium Phosphate ◽  
Kidney Disease ◽  
Metabolic Disorder ◽  
Serum Phosphate ◽  
Phosphate Level ◽  
Advanced Stages ◽  
Phosphate Product ◽  
Bone Metabolic Disorder

Introduction: The prevalence of bone mineral disorder is best known in end-stage renal disease (ESRD) patients, but less data is available for the earlier stages. Objectives: We aimed to compare the prevalence of bone metabolic disorder at all stages of chronic kidney disease (CKD) and assess its contribution to CKD progression and patients’ outcome. Patients and Methods: In a retrospective cohort study, CKD patients who were under treatment for three years were selected from a nephrology clinic in Tehran, Iran. Patients’ demographic and laboratory data, as well as the outcome of their treatment were gathered and analyzed. Results: In 473 patients with an average age of 61.5, 60.1% were at stage III, 35.8% were at stage IV, and 4.1% were at stage V of CKD. There was a significant relationship between CKD stage and serum phosphate, calcium-phosphate product, and systolic blood pressure (SBP). Furthermore, the patients’ outcome was significantly related to advanced stages of CKD, higher first phosphate level, diabetes mellitus in medical history, and higher stages of SBP. By multiple Cox regression analysis, after adjustment for glomerular filtration rate (GFR), the first serum phosphate level, and the calcium-phosphate product did not contribute to the undesirable outcome. Conclusion: Although bone metabolic disorder is more frequently seen in advanced stages of chronic kidney disease, these changes can be seen even in earlier stages of the disease. The influence of phosphate abnormality in the patients’ outcome should be studied more in earlier stages for better control.

The Influence of Physical Activity on Serum Phosphate Levels in a Group of Hemodialysis Patients

2017 ◽  
Vol 68 (7) ◽  
pp. 1581-1585
Author(s):  
Andra Elena Balcangiu Stroescu ◽  
Ileana Peride ◽  
Alexandra Maria Constantin ◽  
Cristiana David ◽  
Ruxandra Diana Sinescu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Risk ◽  
Serum Calcium ◽  
Daily Intake ◽  
Elevated Serum ◽  
Dry Weight ◽  
Serum Phosphate ◽  
Serum Phosphate Level ◽  
Individual Level ◽  
Dialysis Vintage

The prevalence of mineral bone disorders in chronic kidney disease (MBD-CKD) and the cardiovascular risk are increased in hemodialysis (HD) patients. Hyperphosphatemia is one of the complications often associated with increased cardiovascular risk, and in CKD patients, the reduced renal excretion of phosphate is an important cause of elevated serum of this microelement. Physical activity represents another contributing factor in evaluating the risk of cardiovascular disease. The aim of our study was to determine the influence of physical activity on serum phosphate levels in HD patients. The inclusion criteria of this 3-months study were: age ] 18 years old, dialysis vintage ] 6-months, diuresis ] 500 mL/day, PTH values between 100-500 pg/mL, similar dialysis protocol, phosphate daily intake and MBD-CKD therapy. The following parameters were monitored: dry weight, diuresis, associated comorbidities, hemoglobin, serum calcium, phosphate, sodium, potassium, serum albumin, intact parathormon, bicarbonate. The physical activity was assessed during 4 days (3 week-days and 1 during the week-end) for 3 months, and the patients had to complete a questionnaire, too. 49 patients were included and divided in 5 groups, depending on their physical activity. Analyzing the parameters influence on serum phosphate levels, we observed that physical activity, serum calcium and albumin were the only parameters statistically significant (p = 0.001, p = 0.033, and p = 0.47, respectively). The nutritional recommendations of chronic HD patients should be adapted to their individual level of physical activity, in order to avoid an abnormal increase of serum phosphate level, and to improve to over-all outcome.

Elevated admission serum calcium phosphate product as an independent risk factor for acute kidney injury in hospitalized patients

2019 ◽  
Vol 47 (2) ◽  
pp. 73-79 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Michael A. Mao ◽  
Andrew M. Harrison ◽  
Stephen B. Erickson
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Calcium Phosphate ◽  
Serum Calcium ◽  
Independent Risk Factor ◽  
Kidney Injury ◽  
Hospitalized Patients ◽  
Phosphate Product

scholarly journals Prevalence of Cardiovascular Risk Factors among Chronic Kidney Disease Patients Undergoing Hemodialysis in a Tertiary Care Center, Kathmandu, Nepal

2019 ◽  
Vol 21 (4) ◽  
pp. 313-318
Author(s):  
A Pokhrel ◽  
P. Gyawali ◽  
BR Pokhrel ◽  
M P Khanal ◽  
D N Manandhar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Calcium Phosphate ◽  
Kidney Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Maintenance Hemodialysis ◽  
Tertiary Care Center ◽  
Phosphate Product

The risk of cardiovascular disease is higher in chronic kidney disease patients compared to the general population and its impact is higher in developing countries compared to the developed countries. With this background in mind, we aimed to evaluate the prevalence of different cardiovascular risk factors in patients on maintenance hemodialysis in a tertiary care center. Chronic kidney disease patients aged 18 years and above who were under maintenance hemodialysis in the hemodialysis unit of Nepal Medical College were included in the study. Pre-dialysis venous blood samples from the participants were collected and analyzed for serum calcium, phosphorus, total protein, albumin and hemoglobin. Calcium phosphate product was calculated. Out of 100 study participants, 52% were male and 48% were female. Age-wise distribution showed 38% of the participants were below 40 years. The mean age of the participants was 45.86 ± 14.4 years. Ninety-three percent had hypertension and 29% had diabetes mellitus. Hypocalcemia was present in 80%, hyperphosphatemia was seen among 81% and high calcium phosphate product was present in 33% of the participants. Low hemoglobin (< 10gm/dL) was found in 86%. The cardiovascular risk trend in the Nepalese chronic kidney disease population is fairly different compared to the western population. Participants were younger. Prevalence of hypertension and diabetes was high. The high prevalence of anemia might be due to unaffordability of the participants for regular erythropoietin therapy. Inadequately managed hyperphosphatemia despite the widespread use of phosphorus binders, is still a major clinical challenge in patients on hemodialysis.

scholarly journals Therapy of Hypoparathyroidism With rhPTH(1-84): A Prospective, 8-Year Investigation of Efficacy and Safety

2019 ◽  
Vol 104 (11) ◽  
pp. 5601-5610 ◽  
Author(s):  
Yu-Kwang Donovan Tay ◽  
Gaia Tabacco ◽  
Natalie E Cusano ◽  
John Williams ◽  
Beatriz Omeragic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Renal Function ◽  
Calcium Phosphate ◽  
Serum Calcium ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Calcium Excretion ◽  
Mineral Density ◽  
Supplemental Calcium ◽  
Phosphate Product

Abstract Context Conventional treatment of hypoparathyroidism is associated with decreased renal function and increased bone mineral density (BMD). Objective To evaluate the effects of 8 years of recombinant human parathyroid hormone (1-84) [rhPTH(1-84)] therapy on key biochemical and densitometric indices. Design Prospective open-label trial. Setting Tertiary medical center. Participants Twenty-four subjects with hypoparathyroidism. Intervention Treatment with rhPTH(1-84) for 8 years. Main Outcome Measures Supplemental calcium and vitamin D requirements, serum calcium and phosphorus levels, calcium-phosphate product, urinary calcium excretion, estimated glomerular filtration rate (eGFR) and BMD. Results PTH therapy was associated with progressive reduction in supplemental calcium (57%; P < 0.01) and active vitamin D (76%; P < 0.001) requirements over 8 years. Serum calcium concentration was stable; urinary calcium excretion declined 38% (P < 0.01). eGFR remained stable and was related to baseline eGFR and serum calcium levels. Calcium-phosphate product was below the recommended limit; serum phosphorus remained within normal range. Lumbar spine and total hip BMD increased, peaking at 4 (mean ± SE, 4.6% ± 1.5%; P = 0.01) and 8 years (2.6% ± 1.1%; P = 0.02), whereas femoral neck BMD did not change and one-third radius BMD decreased (mean ± SE, −3.5% ± 1.1%; P = 0.001). BMD at all sites was higher throughout the 8 years than in the age- and sex-matched reference population. Hypercalcemia and hypocalcemia were uncommon. Conclusion rhPTH(1-84) is a safe and effective treatment for hypoparathyroidism for 8 years. Long-term reductions in supplemental requirements and biochemical improvements with stable renal function are maintained.

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