Regulation of urinary calcium excretion by vasopressin

Abstract Background The antidiuretic hormone (ADH) or arginine vasopressin (AVP) regulates the body's water balance. Recently, modifications in AVP levels have been related to osteoporosis during ageing and microgravity/bed rest. Therefore the present study was devised to assess whether the absence of AVP, as in patients with central diabetes insipidus (CDI), modulates renal calcium excretion. Methods We retrospectively analysed data from 12 patients with CDI with measured 24-h urinary excretion levels of calcium. Data were available at the moment of the diagnosis when patients were drug-free and after therapy with dDAVP, an analog of AVP. Hypercalciuria was defined as 24-h urinary Ca2+ >275 mg/day in males and >250 mg/day in females and a urinary calcium (Ca):creatinine (Cr) ratio >0.20 mg/mg. Results Untreated CDI patients had a daily urinary Ca2+ excretion of 383 ± 47 mg/day and a urinary Ca:Cr ratio of 0.26 ± 0.38 mg/mg. The urine osmolarity significantly increased after the administration of dDAVP by 210% and the urinary flow decreased by 72%. Furthermore, the estimated glomerular filtration rate (eGFR) increased by 7%, which did not reach statistical significance. dDAVP treatment did not significantly modify the urinary Ca2+ concentration; however, the daily calcium excretion and the urinary Ca:Cr ratio were significantly decreased (160 ± 27 mg/day and 0.11 ± 0.02 mg/mg, respectively). Conclusions Patients with CDI show hypercalciuria even though urine is more diluted than normal controls, and dDAVP reverses this effect. These data support the intriguing relationship between AVP and osteoporosis in ageing and microgravity/bed rest.

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THE DEPENDENCE OF URINARY CALCIUM AND OTHER ELECTROLYTES ON ADRENAL FUNCTION DURING ACUTE SODIUM DEPLETION AND LOADING

Acta Endocrinologica ◽

10.1530/acta.0.0640065 ◽

1970 ◽

Vol 64 (1) ◽

pp. 65-74 ◽

Cited By ~ 1

Author(s):

Lars Runeberg ◽

B.-A. Lamberg ◽

P. Reissell ◽

H. Adlercreutz

Keyword(s):

Sodium Excretion ◽

Extracellular Volume ◽

Normal Subjects ◽

Urinary Calcium ◽

Calcium Excretion ◽

Minor Importance ◽

Sodium Depletion ◽

Sodium Loading ◽

Urinary Potassium ◽

Normal Controls

ABSTRACT The time course of the renal excretion of calcium, magnesium, sodium, and potassium during sodium depletion and the rapid correction of the extracellular volume deficit was studied in normal subjects and in patients with Addison's disease (AD). The decrease in body weight was similar in the two groups, but the haematocrit value increased more in the patients with AD. Sodium depletion suppressed sodium excretion much more efficiently in normal controls than in the AD patients. Calcium excretion was roughly equally depressed in two groups. During sodium loading there was an immediate increase in renal sodium excretion in the patients with AD, whereas the sodium-retaining state generally continued for about one day in the normal controls. Urinary potassium decreased gradually during the first day of sodium loading in the normal controls but not in the AD patients. In the normal subjects calcium excretion remained low during the first day and increased on the second day of sodium loading. In the AD patients there was a gradual increase in urinary calcium during the first day of sodium loading, which did not, however, parallel the changes in urinary sodium content in individual urine samples. Urinary magnesium did not change significantly. It is concluded that the effect of adrenal steroids on renal calcium excretion is of minor importance. They may, however, to some extent induce calcium retention.

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Bone resorption is induced on the second day of bed rest: results of a controlled crossover trial

Journal of Applied Physiology ◽

10.1152/japplphysiol.00264.2003 ◽

2003 ◽

Vol 95 (3) ◽

pp. 977-982 ◽

Cited By ~ 60

Author(s):

Natalie Baecker ◽

Aleksandra Tomic ◽

Claudia Mika ◽

Andrea Gotzmann ◽

Petra Platen ◽

...

Keyword(s):

Bone Resorption ◽

Rest Period ◽

Bed Rest ◽

Urinary Calcium ◽

Significant Rise ◽

Calcium Excretion ◽

Bone Formation Markers ◽

Kinetics Of ◽

Male Subjects ◽

Amino Acid Concentrations

The aim of the study was to analyze the kinetics of short-term changes in bone turnover. We studied in a randomized crossover design the effects of 6 days of bed rest on eight healthy male subjects (mean body wt: 70.1 ± 5.7 kg; mean age: 25.5 ± 2.9 yr). The metabolic ward period was divided into three parts: 4 ambulatory days, 6 days of either bed rest or non-bed rest periods, and 1 recovery day. The diet was identical in both bed rest and non-bed rest phases. Continuous urine collection started on the first day in the metabolic ward to analyze excretion of bone resorption markers, namely C-telopeptide (CTX) and N-telopeptide (NTX), creatinine, urea, and 3-methylhistidine. On the second ambulatory day and on the fifth day of bed rest or during the non-bed rest phase, blood was drawn to analyze bone formation markers and amino acid concentrations. Urinary calcium excretion was increased as early as the first day of bed rest ( P < 0.01). CTX and NTX excretion stayed unchanged during the first 24 h of bed rest compared with the non-bed rest period. However, already on the second day, both resorption markers had increased significantly. NTX excretion increased by 28.7 ± 14.0% ( P < 0.01), whereas CTX excretion rose by 17.8 ± 8.3% ( P < 0.001). Creatinine, urea, and 3-methylhistidine excretion did not change. We conclude that 24 h of bed rest are sufficient to induce a significant rise in osteoclast activity in healthy subjects.

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Association between Urinary Calcium Excretion and Estimated Glomerular Filtration Rate Decline in Patients with Type 2 Diabetes Mellitus: A Retrospective Single-center Observational Study

Journal of Clinical Medicine ◽

10.3390/jcm7070171 ◽

2018 ◽

Vol 7 (7) ◽

pp. 171

Author(s):

Hodaka Yamada ◽

Shunsuke Funazaki ◽

Daisuke Suzuki ◽

Rika Saikawa ◽

Masashi Yoshida ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Urinary Calcium ◽

Calcium Excretion ◽

Single Center ◽

Glomerular Filtration Rate Decline ◽

Single Center Observational Study

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Long-Term Influence of Calcitriol (1,25-Dihydroxyvitamin D) and Supplemental Phosphate in X-Linked Hypophosphatemic Rickets

PEDIATRICS ◽

10.1542/peds.71.4.559 ◽

1983 ◽

Vol 71 (4) ◽

pp. 559-567 ◽

Cited By ~ 1

Author(s):

Russell W. Chesney ◽

Richard B. Mazess ◽

Philip Rose ◽

Alan J. Hamstra ◽

Hector F. DeLuca ◽

...

Keyword(s):

Bone Mineralization ◽

Statistical Significance ◽

Urinary Calcium ◽

Hypophosphatemic Rickets ◽

Calcium Excretion ◽

Vitamin D2 ◽

Photon Absorptiometry ◽

Dihydroxyvitamin D ◽

Familial Form

Ten patients with hypophosphatemic rickets (eight with X-linked familial form) were treated with vitamin D2 (10,000 to 75,000 units per day) and oral phosphate (1.5 to 3.6 gm) for a total of 438 treatment months. Therapy was then changed to calcitriol (17 to 34 ng/kg/day) and the same phosphate dose. Patients served as their own controls, and significant biochemical changes noted were an increase in immunoreactive parathyroid hormone from 29 ± 9 (SD) µlEq/ml (pre-phosphate) to 62 ± 34 on vitamin D2 plus PO4, then decreasing to 40 ± 20 on a regimen of 1,25-dthydroxyvitamin D (1,25(OH)2D) plus PO4; serum PO4 rose from 2.44 ± 0.45 (SD) mg/100 ml to 3.06 ± 0.79 and then to 3.43 ± 0.76; alkaline phosphatase activity decreased from 677 ± 298 (SD) UI/liter to 457 ± 183 to 290 ± 176. Serum calcium and creatinine levels were unchanged. Both urinary calcium excretion and caicium-creatinine ratio decreased after therapy with 1,25(OH)2D. Urinary phosphate excretion was higher after calcitriol administration. Serum 1,25(OH)2D levels were low in these vitamin D2-treated patients, and an inverse relationship between serum 25(OH)D and 1,25(OH)2D was found. Improved bone mineralization was evident from serial assessment by photon absorptiometry, and radial bone mineral content rose from 75.3% ± 2.2% of expected to 82.2% ± 1.4% (P < .005). Stature was improved when assessed by standard deviation for chronologic age but did not reach statistical significance. Long-term 1,25(OH)2D plus phosphate therapy appears to be more efficacious than vitamin D2 in this form of rickets, particularly in improving phosphate homeostasis.

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Furosemide Increases the Risk of Hyperparathyroidism in Chronic Kidney Disease

American Journal of Nephrology ◽

10.1159/000446449 ◽

2016 ◽

Vol 43 (6) ◽

pp. 421-430 ◽

Cited By ~ 6

Author(s):

Raquel F.V. Vasco ◽

Rosa M.A. Moyses ◽

Roberto Zatz ◽

Rosilene M. Elias

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Biochemical Parameters ◽

Estimated Glomerular Filtration Rate ◽

Excretion Rate ◽

Strong Predictor ◽

Urinary Calcium ◽

Urinary Calcium Excretion ◽

Calcium Excretion ◽

Advanced Stages

Background: Diuretics are widely used in patients with chronic kidney disease (CKD). While thiazide-like diuretics limit urinary calcium excretion, loop diuretics (LD) promote calcium wasting, which might facilitate the development of secondary hyperparathyroidism (HPT2). We sought to investigate, in CKD patients not on dialysis, the influence of either hydrochlorothiazide (Hydro) or furosemide (Furo) on circulating parathyroid hormone (PTH) and whether such actions are determined by the effects of these compounds on calcium excretion. Methods: Electronic charts of all nephrology outpatients (CKD stages 2-5) who were given Hydro or Furo were included. We assessed estimated glomerular filtration rate (eGFR), biochemical parameters and 24-hour calcium excretion. Hyperparathyroidism was defined as PTH >65 pg/ml. Results: Out of 275 patients, 108 (29%) were taking Hydro and 167 (61%) Furo. Patients on Hydro were younger, mostly female and had higher eGFR. The median 24-hour urinary calcium excretion in the overall cohort was 41 (22, 76), being lower in Furo than in Hydro patients (37 (16, 68) vs. 47 (26, 88) mg/24 h, respectively, p = 0.016). Logistic regression showed that, after adjustment for eGFR, calcium excretion rate was found not to increase the risk ratio for HPT2, whereas Furo was a strong predictor of HPT2. Conclusion: Furo increased the risk of HPT2 among CKD patients compared to Hydro. This effect was independent of eGFR or calcium excretion. The use of LD in CKD, currently preferred in advanced stages, should be reappraised.

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Multiple urolithiases in pediatric acute lymphoblastic leukemia

Indian Journal of Child Health ◽

10.32677/ijch.v8i9.3032 ◽

2021 ◽

Vol 8 (9) ◽

pp. 340-342

Author(s):

Ayumi Fujishiro ◽

Ryosuke Matsuno ◽

Taichi Omachi ◽

Takashi Yamazoe ◽

Mai Okano ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Bed Rest ◽

Urinary Calcium ◽

Calcium Excretion ◽

Fluid Restriction ◽

Pediatric Acute Lymphoblastic Leukemia ◽

Inappropriate Secretion ◽

Cell Acute Lymphoblastic Leukemia

Current study is a case report of a 5-year-old patient with T-cell acute lymphoblastic leukemia (ALL) and multiple urolithiasis. Complex factors, including glucocorticoid-induced hypercalciuria, fluid restriction for the syndrome of inappropriate secretion of antidiuretic hormone, and long-term bed rest, predispose children with ALL to develop urolithiasis. To prevent urinary urolithiasis formation, urinary calcium excretion should be monitored during chemotherapy and when administering glucocorticoids.

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