Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones

Piergiorgio Messa, Martino Marangella, Luisa Paganin, Mara Codardini, Aldo Cruciatti, Daniela Turrin, Zattoni Filiberto, Giuseppe Mioni

Research output: Contribution to journalArticle

Abstract

1. Dietary calcium restriction, an efficient practice in reducing urinary calcium excretion, has been reported to induce either an increase or no change in oxalate excretion, questioning its use in hypercalciuric stone-forming patients. In addition, calcium restriction has been previously demonstrated to induce other urinary changes which might influence the relative supersaturation of calcium oxalate. So the overall effect of calcium deprivation on the relative supersaturation of calcium oxalate is unpredictable. 2. The aim of the study was to evaluate the effect of dietary calcium restriction on the relative supersaturation of calcium oxalate in the urine of stone-forming patients utilizing a computer methodology which takes into account the main soluble complex species of oxalate. 3. We studied 34 stone-forming patients on both a free-choice diet, whose Ca and oxalate content (24 and 1.2 mmol respectively) was assessed by dietary inquiry, and after 30 days on a prescribed low-calcium and normal oxalate diet (11 and 1.1 mmol respectively). Under both conditions, the excretion of the main urinary parameters related to dietary composition, electrolytes, oxalate and daily citrate urinary excretion, were measured. The relative supersaturation of calcium oxalate was calculated by means of an iterative computer method which takes into account the main soluble complex species on which the solubility of calcium oxalate is dependent. In addition, intact parathyroid hormone and 1,25-dihydroxyvitamin D blood levels were also evaluated. In 13 of the patients intestinal calcium absorption was evaluated during both a free- and a low-calcium diet, utilizing kinetics methodology. 4. The low-calcium diet induced, together with an expected reduction of calcium excretion, a marked increase in oxalate urinary output. This finding was independent of the presence or otherwise of hypercalciuria and of the serum levels of parathyroid hormone and vitamin D. Intestinal calcium absorption was also stimulated by calcium deprivation and its levels were well correlated with oxalate excretion. Minor changes in magnesium and citrate excretion were also observed. The overall effect on the relative supersaturation of calcium oxalate consisted in a substantial increase in this parameter during the low-calcium diet. 5. In conclusion, our data reinforce the concept that dietary calcium restriction has potentially deleterious effects on lithogenesis, by increasing the relative supersaturation of calcium oxalate.

Original languageEnglish
Pages (from-to)257-263
Number of pages7
JournalClinical Science
Volume93
Issue number3
Publication statusPublished - 1997

Fingerprint

Dietary Calcium
Calcium Oxalate
Urine
Oxalates
Calcium
Kidney
Diet
Intestinal Absorption
Parathyroid Hormone
Hypercalciuria
Vitamin D
Citric Acid
Solubility
Electrolytes

Keywords

  • Bone
  • Bone resorption
  • Calcium oxalate
  • Diet
  • Urolithiasis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Messa, P., Marangella, M., Paganin, L., Codardini, M., Cruciatti, A., Turrin, D., ... Mioni, G. (1997). Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones. Clinical Science, 93(3), 257-263.

Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones. / Messa, Piergiorgio; Marangella, Martino; Paganin, Luisa; Codardini, Mara; Cruciatti, Aldo; Turrin, Daniela; Filiberto, Zattoni; Mioni, Giuseppe.

In: Clinical Science, Vol. 93, No. 3, 1997, p. 257-263.

Research output: Contribution to journalArticle

Messa, P, Marangella, M, Paganin, L, Codardini, M, Cruciatti, A, Turrin, D, Filiberto, Z & Mioni, G 1997, 'Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones', Clinical Science, vol. 93, no. 3, pp. 257-263.
Messa, Piergiorgio ; Marangella, Martino ; Paganin, Luisa ; Codardini, Mara ; Cruciatti, Aldo ; Turrin, Daniela ; Filiberto, Zattoni ; Mioni, Giuseppe. / Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones. In: Clinical Science. 1997 ; Vol. 93, No. 3. pp. 257-263.
@article{3408dd20f50a4c308129516cdd15aa22,
title = "Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones",
abstract = "1. Dietary calcium restriction, an efficient practice in reducing urinary calcium excretion, has been reported to induce either an increase or no change in oxalate excretion, questioning its use in hypercalciuric stone-forming patients. In addition, calcium restriction has been previously demonstrated to induce other urinary changes which might influence the relative supersaturation of calcium oxalate. So the overall effect of calcium deprivation on the relative supersaturation of calcium oxalate is unpredictable. 2. The aim of the study was to evaluate the effect of dietary calcium restriction on the relative supersaturation of calcium oxalate in the urine of stone-forming patients utilizing a computer methodology which takes into account the main soluble complex species of oxalate. 3. We studied 34 stone-forming patients on both a free-choice diet, whose Ca and oxalate content (24 and 1.2 mmol respectively) was assessed by dietary inquiry, and after 30 days on a prescribed low-calcium and normal oxalate diet (11 and 1.1 mmol respectively). Under both conditions, the excretion of the main urinary parameters related to dietary composition, electrolytes, oxalate and daily citrate urinary excretion, were measured. The relative supersaturation of calcium oxalate was calculated by means of an iterative computer method which takes into account the main soluble complex species on which the solubility of calcium oxalate is dependent. In addition, intact parathyroid hormone and 1,25-dihydroxyvitamin D blood levels were also evaluated. In 13 of the patients intestinal calcium absorption was evaluated during both a free- and a low-calcium diet, utilizing kinetics methodology. 4. The low-calcium diet induced, together with an expected reduction of calcium excretion, a marked increase in oxalate urinary output. This finding was independent of the presence or otherwise of hypercalciuria and of the serum levels of parathyroid hormone and vitamin D. Intestinal calcium absorption was also stimulated by calcium deprivation and its levels were well correlated with oxalate excretion. Minor changes in magnesium and citrate excretion were also observed. The overall effect on the relative supersaturation of calcium oxalate consisted in a substantial increase in this parameter during the low-calcium diet. 5. In conclusion, our data reinforce the concept that dietary calcium restriction has potentially deleterious effects on lithogenesis, by increasing the relative supersaturation of calcium oxalate.",
keywords = "Bone, Bone resorption, Calcium oxalate, Diet, Urolithiasis",
author = "Piergiorgio Messa and Martino Marangella and Luisa Paganin and Mara Codardini and Aldo Cruciatti and Daniela Turrin and Zattoni Filiberto and Giuseppe Mioni",
year = "1997",
language = "English",
volume = "93",
pages = "257--263",
journal = "Clinical Science",
issn = "0143-5221",
publisher = "Portland Press Ltd.",
number = "3",

}

TY - JOUR

T1 - Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones

AU - Messa, Piergiorgio

AU - Marangella, Martino

AU - Paganin, Luisa

AU - Codardini, Mara

AU - Cruciatti, Aldo

AU - Turrin, Daniela

AU - Filiberto, Zattoni

AU - Mioni, Giuseppe

PY - 1997

Y1 - 1997

N2 - 1. Dietary calcium restriction, an efficient practice in reducing urinary calcium excretion, has been reported to induce either an increase or no change in oxalate excretion, questioning its use in hypercalciuric stone-forming patients. In addition, calcium restriction has been previously demonstrated to induce other urinary changes which might influence the relative supersaturation of calcium oxalate. So the overall effect of calcium deprivation on the relative supersaturation of calcium oxalate is unpredictable. 2. The aim of the study was to evaluate the effect of dietary calcium restriction on the relative supersaturation of calcium oxalate in the urine of stone-forming patients utilizing a computer methodology which takes into account the main soluble complex species of oxalate. 3. We studied 34 stone-forming patients on both a free-choice diet, whose Ca and oxalate content (24 and 1.2 mmol respectively) was assessed by dietary inquiry, and after 30 days on a prescribed low-calcium and normal oxalate diet (11 and 1.1 mmol respectively). Under both conditions, the excretion of the main urinary parameters related to dietary composition, electrolytes, oxalate and daily citrate urinary excretion, were measured. The relative supersaturation of calcium oxalate was calculated by means of an iterative computer method which takes into account the main soluble complex species on which the solubility of calcium oxalate is dependent. In addition, intact parathyroid hormone and 1,25-dihydroxyvitamin D blood levels were also evaluated. In 13 of the patients intestinal calcium absorption was evaluated during both a free- and a low-calcium diet, utilizing kinetics methodology. 4. The low-calcium diet induced, together with an expected reduction of calcium excretion, a marked increase in oxalate urinary output. This finding was independent of the presence or otherwise of hypercalciuria and of the serum levels of parathyroid hormone and vitamin D. Intestinal calcium absorption was also stimulated by calcium deprivation and its levels were well correlated with oxalate excretion. Minor changes in magnesium and citrate excretion were also observed. The overall effect on the relative supersaturation of calcium oxalate consisted in a substantial increase in this parameter during the low-calcium diet. 5. In conclusion, our data reinforce the concept that dietary calcium restriction has potentially deleterious effects on lithogenesis, by increasing the relative supersaturation of calcium oxalate.

AB - 1. Dietary calcium restriction, an efficient practice in reducing urinary calcium excretion, has been reported to induce either an increase or no change in oxalate excretion, questioning its use in hypercalciuric stone-forming patients. In addition, calcium restriction has been previously demonstrated to induce other urinary changes which might influence the relative supersaturation of calcium oxalate. So the overall effect of calcium deprivation on the relative supersaturation of calcium oxalate is unpredictable. 2. The aim of the study was to evaluate the effect of dietary calcium restriction on the relative supersaturation of calcium oxalate in the urine of stone-forming patients utilizing a computer methodology which takes into account the main soluble complex species of oxalate. 3. We studied 34 stone-forming patients on both a free-choice diet, whose Ca and oxalate content (24 and 1.2 mmol respectively) was assessed by dietary inquiry, and after 30 days on a prescribed low-calcium and normal oxalate diet (11 and 1.1 mmol respectively). Under both conditions, the excretion of the main urinary parameters related to dietary composition, electrolytes, oxalate and daily citrate urinary excretion, were measured. The relative supersaturation of calcium oxalate was calculated by means of an iterative computer method which takes into account the main soluble complex species on which the solubility of calcium oxalate is dependent. In addition, intact parathyroid hormone and 1,25-dihydroxyvitamin D blood levels were also evaluated. In 13 of the patients intestinal calcium absorption was evaluated during both a free- and a low-calcium diet, utilizing kinetics methodology. 4. The low-calcium diet induced, together with an expected reduction of calcium excretion, a marked increase in oxalate urinary output. This finding was independent of the presence or otherwise of hypercalciuria and of the serum levels of parathyroid hormone and vitamin D. Intestinal calcium absorption was also stimulated by calcium deprivation and its levels were well correlated with oxalate excretion. Minor changes in magnesium and citrate excretion were also observed. The overall effect on the relative supersaturation of calcium oxalate consisted in a substantial increase in this parameter during the low-calcium diet. 5. In conclusion, our data reinforce the concept that dietary calcium restriction has potentially deleterious effects on lithogenesis, by increasing the relative supersaturation of calcium oxalate.

KW - Bone

KW - Bone resorption

KW - Calcium oxalate

KW - Diet

KW - Urolithiasis

UR - http://www.scopus.com/inward/record.url?scp=0030984110&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030984110&partnerID=8YFLogxK

M3 - Article

C2 - 9337641

AN - SCOPUS:0030984110

VL - 93

SP - 257

EP - 263

JO - Clinical Science

JF - Clinical Science

SN - 0143-5221

IS - 3

ER -