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Query: UMLS:C0020438 (hypercalciuria)
 2,502 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The influence of continuous imbalanced high protein intake on the metabolism of minerals (calcium, magnesium, phosphorus) and renal function was the subject of a long-term experiment with rats. In the first part of the study particular attention was directed to the contribution of protein-induced endogenous acid production and renal excretion of hydrogen ions and sulphate to the development of hypercalciuria. For 61 weeks 200 male Wistar rats in eight groups were fed isocaloric diets, whose protein contents were increased from 13 to 26 and 40 J% at the expense of carbohydrate intake. The fat content of the diets was 40 J%. In two groups with 13 and 26 J% protein the effect of different kinds of animal protein was also studied, replacing casein by beef. Mineral contents were kept constant in these diets. To examine the excretion mechanisms of calcium and phosphorus especially under conditions of excessive protein intake, the ratio of calcium to phosphorus was varied in three diets with 40 J% protein by increasing both minerals alternatively or together from 0.6 to 1.2%. An increase in dietary protein content from 13 to 26 or 40 J% produced a sustained hypercalciuria and also hypermagnesiuria over a period of more than 400 days (after 58 weeks: 3.3, 5.9, and 6.8 mg calcium/day; 2.2, 3.3, and 3.4 mg magnesium/day; p less than or equal to 0.05). No adaptation to high protein intake occurred. Hypermagnesiuria, which equally hasn't been described before as a result of high protein intake, was accompanied by a reduced fecal excretion of magnesium. With increased protein intake (casein and beef) hypercalciuria and also hypermagnesiuria were positively correlated with an increased formation and renal excretion of hydrogen ions and sulphate, which resulted from protein catabolism. The dietary protein source influenced the extent of hypercalciuria, irrespective of a constant phosphorus intake. Although leading to equal increases in renal total acid and sulphate excretion, beef as the main protein source caused a lower calciuria than casein. High phosphorus intake caused the highest total acid excretion of all groups, but resulted in a reduced hypercalciuria and hypermagnesiuria and counteracted the influence of an increased protein intake.
Z Ernahrungswiss 1988 Sep
PMID:[The effect of long-term increased protein administration on mineral metabolism and kidney function in the rat. I. Renal and enteral excretion of calcium, magnesium, phosphorus, sulfate and acid]. 323 5

In the Federal Republic of Germany the average daily protein intake exceeds the Recommended Dietary Allowances for adults (0.8 g protein/kg body weight) by about 100%. On the other hand calcium intake is below the recommendations for certain age groups. Protein-induced hypercalciuria involves the risk of depletion of skeletal calcium stores, especially for older people who have a decreased absorption capacity for calcium. As a result of our study we postulate, that an altered renal function probably is one inducing factor of hypercalciuria. While urea excretion and serum urea concentration increased with an elevated dietary protein content from 13 to 26 or 40 J%, glomerular filtration rate remained unchanged. Fractional tubular reabsorption of calcium was significantly reduced by about 3% with increased endogenous acid production and renal excretion of hydrogen ions (first part of the study), which were accompanying a higher protein intake of 40 J% compared to 13 J% protein in the control group. Increasing the phosphorus content of the diet improved the reabsorption of calcium and magnesium. The kidneys of rats fed diets high in protein and phosphorus were hypertrophied. Histology of the kidneys showed signs of glomerulonephrosis. While the calcium content of the femora was slightly reduced with a higher protein intake of 40 compared to 13 J%, the magnesium content was increased (after 61 weeks: calcium from 261.4 to 257.1 mg/g dry fat-free wt [p less than or equal to 0.05]; magnesium from 3.2 to 3.5 mg/g dry fat-free wt [p less than or equal to 0.001]). Calcium and magnesium metabolism depends not only on the level of protein intake, but also on its interrelation with the dietary phosphorus content. With continuous high protein intake higher intakes for calcium, phosphorus and magnesium should be recommended, especially for older people.
Z Ernahrungswiss 1988 Sep
PMID:[The effect of long-term increased protein administration on mineral metabolism and kidney function in the rat. II. Kidney function and bone mineralization]. 323 6

The association of various diuretic therapies with the renal handling of minerals, important factors in the development of nephrocalcinosis and osteopenia, was studied in low birth weight infants. Twenty-four-hour urine specimens (n = 65) were collected from 30 patients who were treated with (1) furosemide with or without spironolactone and hydrochlorothiazide (2) spironolactone with hydrochlorothiazide, (3) spironolactone alone, or (4) no diuretic (control; i.e., after diuretic). Hypercalciuria (urinary calcium greater than or equal to 0.15 mmol/kg/day) was observed in all but the control group. Covariate analysis demonstrated a significant effect of sodium, calcium, and vitamin D intakes (p less than 0.01) and sodium excretion (p less than 0.05) on urinary calcium excretion. Treatment with any of these diuretics in neonates may be associated with abnormal renal losses of calcium, sodium, chloride, and potassium. From a nutritional perspective, neonates requiring long-term diuretic therapy thereby require special consideration, including monitoring of mineral excretion and renal ultrasonography.
J Pediatr 1988 Sep
PMID:Mineral excretion in premature infants receiving various diuretic therapies. 341 1

Thirty-six patients with recurrent calcium oxalate nephrolithiasis were selected from the stone clinic. Fourteen were normocalcemic and had normal daily urinary calcium excretion. Among 22 patients with idiopathic hypercalciuria, 10 received thiazide diuretics for the prevention of new stone formation. Single-voided urine samples were collected at the outpatient clinic and 24-hour urine at the patients' homes. In hypercalciuric patients, irrespective of thiazide diuretic therapy, the mean value of the calcium/creatinine concentration ratios of postprandial single-voided urine specimens had a meaningful correlation with the man value of 24-hour urinary calcium excretion rates. Also in hypercalciuric patients with thiazide diuretics, a negative correlation was observed between the calcium/creatinine concentration ratio and the index for urinary saturation with calcium oxalate of a postprandial single-voided urine sample. Thus, in the hypercalciuric stone formers, 24-hour urinary calcium excretion rates and the degree of urinary saturation with calcium oxalate can be estimated from the calcium/creatinine concentration ratios of single-voided urinary samples.
Tokai J Exp Clin Med 1987 Sep
PMID:Significance of the calcium to creatinine concentration ratio of a single-voided urine specimen in patients with hypercalciuric urolithiasis. 345 77

The increasing incidence of urolithiasis makes it important to report about 34 children with urolithiasis seen between 1976 and 1986 at the Department of Pediatrics, University Medical School Vienna. At the time of the first diagnosis 59 percent of the patients were less than 7 years of age; 62 percent of our patients were males. Recurrent chronic urinary tract infection in 32 percent, metabolic disorder (secondary hyperoxaluria 5, idiopathic hypercalciuria 3, cystinuria 2, hyperuricuria 2) in 27 percent were evaluated; in 13 patients the origin of calculi was idiopathic. Most infectious stones contained magnesium ammonium phosphate, most idiopathic stones calcium oxalate. In 21 patients (62%) surgical treatment, in one patient extracorporal shock wave lithotripsie was realized. Adequate metaphylaxis (general, dietetic, medicementous) can lower the rate of occurrence of stone formation.
Z Urol Nephrol 1987 Sep
PMID:[Urolithiasis in pediatrics: analysis of 34 patients]. 368 52

Although corticosteroids are effective in the treatment of hypercalciuria and hypercalcemia in chronic sarcoidosis, complications of their long-term use frequently limit therapy. We studied the efficacy of chloroquine in two patients with sarcoidosis who were unable to tolerate the dosage of corticosteroids required to control hypercalciuria and prevent the formation of renal stones. Over a three-year period, each patient received a 6-month and a 10-month course of oral chloroquine phosphate (500 mg per day) while continuing to receive corticosteroids at a fixed dose. Chloroquine therapy was associated with a significant reduction in levels of serum 1,25-dihydroxyvitamin D (1,25(OH)2D) and urinary calcium. We observed a direct correlation between serum 1,25-(OH)2D levels and 24-hour urinary calcium excretion, supporting the hypothesis that excessive serum 1,25-(OH)2D is responsible for the hypercalciuria in sarcoidosis. Serum levels of 25-hydroxyvitamin D (25-(OH)D) did not change with therapy, suggesting that chloroquine may act by inhibiting the conversion of 25-(OH)D to 1,25-(OH)2D. Current dosage guidelines and ophthalmologic-surveillance techniques, which allow chloroquine to be administered with little risk of retinopathy, should permit an expanded role for this agent in the treatment of the calcium abnormalities of sarcoidosis.
N Engl J Med 1986 Sep 18
PMID:The effects of chloroquine on serum 1,25-dihydroxyvitamin D and calcium metabolism in sarcoidosis. 375

An increase in circulating, 1,25-dihydroxyvitamin D level and net intestinal calcium absorption have been previously demonstrated in pregnant women and have been widely regarded as compensatory mechanisms whereby fetal mineral demands are satisfied. The alternate possibility, that these adjustments might anticipate such demands, has not previously been considered. To examine the effects of pregnancy on the intestinal absorption and renal excretion of calcium, oral calcium tolerance tests were performed and urinary calcium excretion was measured in 16 healthy women receiving a moderate calcium intake during and after pregnancy. Circulating 1,25-dihydroxyvitamin D levels and indexes of parathyroid function were also measured. As expected, 1,25-dihydroxyvitamin D levels were significantly (p less than 0.05) elevated throughout pregnancy (94 +/- 11, 118 +/- 9, and 117 +/- 11 pg/ml in the first, second, and third trimesters, respectively, versus 51 +/- 5 pg/ml after delivery). Twenty-four-hour calcium excretion also increased sharply (247 +/- 54, 316 +/- 42, 300 +/- 61 mg versus 91 +/- 18 mg), often to the point of hypercalciuria. Calcium tolerance test results included significant increases in the calciuric and calcemic responses during each trimester, whereas fasting calcium excretion and parathyroid function remained normal. These findings portray normal pregnancy as a state of physiologic absorptive hypercalciuria and call into question the widespread practice of supplementing calcium intake in otherwise well-nourished women during pregnancy.
Am J Med 1986 Sep
PMID:Pregnancy as state of physiologic absorptive hypercalciuria. 375 67

About 80 percent of sarcoidosis cases are benign and do not require treatment, but 20 percent will have chronic unremitting disease for which therapy is essential. It is important that the physician identify this group and begin therapy promptly. If the disease is active, treat. If it is inactive, do not treat. Activity depends upon three major tests: serum angiotensin converting enzyme, gallium 67 scan, and bronchoalveolar lavage. The other consideration is involvement of vital organ systems; ie, active ocular disease, progressive pulmonary involvement as evidenced by increasing symptoms, impaired and deteriorating pulmonary function, or radiographic changes; hypercalcemia or hypercalciuria; central nervous system involvement; disfiguring cutaneous lesions; and myocardial sarcoidosis. Following a therapeutic decision to treat, adrenocorticoids are the drugs of choice. Methylprednisolone, prednisone, and cortisol are listed in order of benefit. Alternate day and/or low-dose steroids are increasing in popularity. Chloroquine phosphate is beneficial for skin lesions, while oxyphenbutazone has been found to be at least as effective as prednisone. Immunosuppressives may be used also. Chlorambucil and azathioprine have shown variable results. Cyclosporine (Cyclosporin A) shows promise and is now undergoing therapeutic trials.
J Natl Med Assoc 1986 Sep
PMID:When should sarcoidosis be treated? 378 58

We evaluated 113 patients with recurrent or multiple calcium urolithiasis at our outpatient stone clinic between 1980 and 1983. Diagnostic categories included hypercalciuria (36 patients), hyperoxaluria (35 patients), and hyperuricosuria (31 patients). Thiazides and/or allopurinol were administered to the hypercalciurics and hyperuricosurics, respectively for prevention of stone recurrence. Patients followed up for more than one year were 23 (male 16, female 7) in the thiazide group, and 15 (male 12, female 3) in the allopurinol group. The mean treatment interval was 2.49 years in the former, and 2.35 years in the latter. The remission rate (percentage of patients without formation of any new stones) was 82.6% in the thiazide group, and 73.3% in the allopurinol group. The group stone formation rate was reduced from 0.85 to 0.35/pt-yr in the thiazide group, and from 0.74 to 0.27/pt-yr in the allopurinol group. Efficacy of these two drugs for the prevention of calcium stone recurrence was observed in this selective therapy, but a careful double blind study should be carried out to draw a definite conclusion.
Hinyokika Kiyo 1986 Sep
PMID:[Experimental and clinical studies on calcium lithiasis. II. Prevention of recurrent calcium stones with thiazides and allopurinol]. 381 44

The effect of two doses of Phosphorus (P) supplementation to pooled breast milk (BM): 0.48 and 0.800 mmol/kg/24 h given during the second month of life was evaluated in 22 very low birthweight infants. The concentration of calcium and phosphorus in serum and urine, the serum concentration of immunoreactive parathyroid hormone (iPTH) and the plasma 1,25-dihydroxy-vitamin D concentration (1,25-OH-D) were compared to the values in 19 control infants. The mean +/- SD concentrations in control infants and adults are 63 +/- 18 microliters Eq/ml for serum iPTH and 85 +/- pmol/l for plasma 1,25-OH-D. With 0.48 P supplementation, urinary Ca (UCa) excretion (median and range) 0.238 mmol/kg/24 h (0.105-0.520) was lower than in the control group 0.288 (0.205-0.679) (p less than 0.05); the reduction of UCa was larger with 0.8 P supplementation: 0.047 (0.023-0.163) (p less than 0.01). P supplementation induced no change in serum Ca concentration but a slight and significant increase in serum iPTH was observed only with the 0.8 P supplementation: 55 microliters Eq/ml (less than 25-80) (p less than 0.05). With 0.8 P supplementation there was no significant change of plasma 1,25-OH-D concentration: 173 pmol/l (106-271) vs. 255 (132-293) in the control group. These data show that with 0.8 P supplementation, the hypercalciuria in BM-fed infant disappears without secondary hyperparathyroidism, but without any change in plasma 1,25-OH-D concentration.
Acta Paediatr Scand 1985 Sep
PMID:Effect of phosphate supplementation to breast fed very low birthweight infants on urinary calcium excretion, serum immunoreactive parathyroid hormone and plasma 1,25-dihydroxy-vitamin D concentration. 384 Mar 17


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