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Literature DB >> 32163150

Disentangling the Relationships Between the Renin-Angiotensin-Aldosterone System, Calcium Physiology, and Risk for Kidney Stones.

Omar Bayomy¹, Sarah Zaheer², Jonathan S Williams¹, Gary Curhan³, Anand Vaidya¹.

Abstract

CONTEXT: Complex relationships between aldosterone and calcium homeostasis have been proposed.
OBJECTIVE: To disentangle the influence of aldosterone and intravascular volume on calcium physiology.
DESIGN: Patient-oriented and epidemiology studies.
SETTING: Clinical research center and nationwide cohorts. PARTICIPANTS/
INTERVENTIONS: Patient-oriented study (n = 18): Participants were evaluated after completing a sodium-restricted (RES) diet to contract intravascular volume and after a liberalized-sodium (LIB) diet to expand intravascular volume. Cross-sectional studies (n = 3755): the association between 24h urinary sodium and calcium excretion and risk for kidney stones was assessed.
RESULTS: Patient-oriented study: compared to a RES-diet, a LIB-diet suppressed renin activity (LIB: 0.3 [0.1, 0.4] vs. RES: 3.1 [1.7, 5.3] ng/mL/h; P < 0.001) and plasma aldosterone (LIB: 2.0 [2.0, 2.7] vs. RES: 20.0 [16.1, 31.0] vs. ng/dL; P < 0.001), but increased calciuria (LIB: 238.4 ± 112.3 vs. RES: 112.9 ± 60.8 mg/24hr; P < 0.0001) and decreased serum calcium (LIB: 8.9 ± 0.3 vs. RES: 9.8 ± 0.4 mg/dL; P < 0.0001). Epidemiology study: mean urinary calcium excretion was higher with greater urinary sodium excretion. Compared to a urinary sodium excretion of < 120 mEq/day, a urinary sodium excretion of ≥220 mEq/day was associated with a higher risk for having kidney stones in women (risk ratio = 1.79 [95% confidence interval 1.05, 3.04]) and men (risk ratio = 2.06 [95% confidence interval 1.27, 3.32]).
CONCLUSIONS: High dietary sodium intake suppresses aldosterone, decreases serum calcium, and increases calciuria and the risk for developing kidney stones. Our findings help disentangle the influences of volume from aldosterone on calcium homeostasis and provide support for the recommendation to restrict dietary sodium for kidney stone prevention. © Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Entities: Chemical Disease Species

Keywords: aldosterone; angiotensin; calcium; kidney stone; parathyroid hormone; renin

Mesh：

Substances：

Year: 2020 PMID： 32163150 PMCID： PMC7185954 DOI： 10.1210/clinem/dgaa123

Source DB: PubMed Journal: J Clin Endocrinol Metab ISSN： 0021-972X Impact factor: 5.958

46 in total

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2. Primary and Secondary Hyperparathyroidism in Patients with Primary Aldosteronism - Findings From the German Conn's Registry.

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7. Alterations of calcium metabolism and of parathyroid function in primary aldosteronism, and their reversal by spironolactone or by surgical removal of aldosterone-producing adenomas.

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Authors: Andreas Tomaschitz; Eberhard Ritz; Burkert Pieske; Astrid Fahrleitner-Pammer; Katharina Kienreich; Jörg H Horina; Christiane Drechsler; Winfried März; Michael Ofner; Thomas R Pieber; Stefan Pilz
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3. Reference range for 24-h urine calcium, calcium/creatinine ratio, and correlations with calcium absorption and serum vitamin D metabolites in normal women.

Authors: L M Smith; J C Gallagher
Journal: Osteoporos Int Date: 2020-09-04 Impact factor: 4.507

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