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Calcium Metabolism and Hypercalciuria

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Urinary Tract Stone Disease

Abstract

Calcium metabolism and homeostasis are highly regulated and maintained within a narrow physiologic range. An understanding of its metabolism and various disorders in absorption and excretion is essential to the understanding of nephrolithiasis. In this chapter, an overview of calcium metabolism in the nephron is presented. The role of diuretic effects on calcium transport is reviewed. Hormonal effects on calcium metabolism are discussed. Various medical treatment options for calcium nephrolithiasis are also presented along with guidelines for therapy.

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References

  1. Amasheh S, Meiri N, Gitter AH, et al. Claudin-2 expression induces cation-selective channels in tight junctions of epithelial cells. J Cell Sci. 2002;115:4969–4976.

    Google Scholar 

  2. Bourdeau J. Calcium transport across the pars recta of cortical segment 2 proximal tubules. Am J Physiol. 1986;251:F718-F724.

    Article  CAS  PubMed  Google Scholar 

  3. Brunette M, Aras M. A microinjection study of nephron permeability to calcium and magnesium. Am J Physiol. 1971;221:1442–1448.

    CAS  PubMed  Google Scholar 

  4. Ng RC, Rouse D, Suki WN. Calcium transport in the rabbit superficial proximal convoluted tubule. J Clin Invest. 1984;74:834–842.

    CAS  PubMed  Google Scholar 

  5. Rocha AS, Magaldi JB, Kokko JP. Calcium and phosphate transport in isolated segments of rabbit Henle’s loop. J Clin Invest. 1977;59:975–983.

    Article  CAS  PubMed  Google Scholar 

  6. Yu A. Renal transport of calcium, magnesium, and phosphate. In: Brenner BM, ed. Brenner and Rector’s The Kidney. Philadelphia: Saunders; 2004:535–572.

    Article  CAS  PubMed  Google Scholar 

  7. Costanzo LS, Windhager EE. Calcium and sodium transport by the distal convoluted tubule of the rat. Am J Physiol (Renal Fluid Electrolyte Physiol). 1978;235:F492-F506.

    Google Scholar 

  8. Imai M. Effects of parathyroid hormone and N6, O2¢-dibutyryl cyclic AMP on Ca2+ transport across the rabbit distal nephron segments perfused in vitro. Pflügers Arch. 1981;390:145–151.

    CAS  Google Scholar 

  9. Shareghi GR, Stoner LC. Calcium transport across segments of the rabbit distal nephron in vitro. Am J Physiol. 1978;235:F367-F375.

    Article  CAS  PubMed  Google Scholar 

  10. Bourdeau JE, Burg MB. Effect of PTH on calcium transport across the cortical thick ascending limb of Henle’s loop. Am J Physiol. 1980;239:F121-F126.

    CAS  PubMed  Google Scholar 

  11. Friedman P. Basal and hormone-activated calcium absorption in mouse renal thick ascending limbs. Am J Physiol. 1988;254:F62-F70.

    CAS  PubMed  Google Scholar 

  12. Lee K, Brown D, Ureña P, et al. Localization of parathyroid hormone/parathyroid hormone-related peptide receptor mRNA in kidney. Am J Physiol. 1996;270:F186-F191.

    CAS  PubMed  Google Scholar 

  13. Costanzo LS, Windhager EE. Effects of PTH, ADH, and cyclic AMP on distal tubular Ca and Na reabsorption. Am J Physiol. 1980;239:F478-F485.

    CAS  PubMed  Google Scholar 

  14. Bacskai BJ, Friedman PA. Activation of latent Ca2+ channels in renal epithelial cells by parathyroid hormone. Nature (London). 1990;347:388–391.

    Article  CAS  Google Scholar 

  15. Shimizu T, Yoshitomi K, Nakamura M, Imai M. Effects of PTH, calcitonin, and cAMP on calcium transport in rabbit distal nephron segments. Am J Physiol. 1990;259:F408-F414.

    CAS  PubMed  Google Scholar 

  16. Bindels RJ, Hartog A, Timmermans J, Van Os CH. Active Ca2+ transport in primary cultures of rabbit kidney CCD: stimulation by 1,25-dihydroxyvitamin D3 and PTH. Am J Physiol. 1991;261:F779-F807.

    Google Scholar 

  17. Hoenderop JG, Dardenne O, Van Abel M, et al. Modulation of renal Ca2+ transport protein genes by dietary Ca2+ and 1,25-dihydroxyvitamin D3 in 25-hydroxyvitamin D3–1alpha-hydroxylase knockout mice. FASEB J. 2002;16:1398–1406.

    Article  CAS  PubMed  Google Scholar 

  18. Firsov D, Bellanger AC, Marsy S, Elalouf JM. Quantitative RT-PCR analysis of calcitonin receptor mRNAs in the rat nephron. Am J Physiol. 1995;269:F702-F709.

    CAS  PubMed  Google Scholar 

  19. Eknoyan G, Suki WN, Martinez-Maldonado M. Effect of diuretics on urinary excretion of phosphate, calcium, and magnesium in thyroparathyroidectomized dogs. J Lab Clin Med. 1970;76:257–266.

    CAS  PubMed  Google Scholar 

  20. Pak CY. Hydrochlorothiazide therapy in nephrolithiasis. Effect on the urinary activity product and formation product of brushite. Clin Pharmacol Ther. 1973;14(2):209–217.

    CAS  PubMed  Google Scholar 

  21. Preminger GM, Pak CY. Eventual attenuation of hypocalciuric response to hydrochlorothiazide in absorptive hypercalciuria. J Urol. 1987;137(6):1104–1109.

    CAS  PubMed  Google Scholar 

  22. Nijenhuis T, Vallon V, van der Kemp AW, Loffing J, Hoenderop JG, Bindels RJ. Enhanced passive Ca2+ reabsorption and reduced Mg2+ channel abundance explains thiazide-induced hypocalciuria and hypomagnesemia. J Clin Invest. 2005;115:1651–1658.

    Article  CAS  PubMed  Google Scholar 

  23. Brickman AS, Massry SG, Coburn JW. Changes in serum and urinary calcium during treatment with hydrochlorothiazide: studies on mechanisms. J Clin Invest. 1972;51:945–954.

    Article  CAS  PubMed  Google Scholar 

  24. Pak CY. Physiological basis for absorptive and renal hypercalciurias. Am J Physiol. 1979;237(6):F415-F423.

    CAS  PubMed  Google Scholar 

  25. Breslau NA, McGuire JL, Zerwekh JE, Pak CY. The role of dietary sodium on renal excretion and intestinal absorption of calcium and on vitamin D metabolism. J Clin Endocrinol Metab. 1982;55(2):369–373.

    Article  CAS  PubMed  Google Scholar 

  26. Pak CY. Calcium metabolism. J Am Coll Nutr. 1989;8(Suppl):46S-53S.

    PubMed  Google Scholar 

  27. Pak CY, Sakhaee K, Hwang TI, Preminger GM, Harvey JA. Nephrolithiasis from calcium supplementation. J Urol. 1987;137(6):1212–1213.

    CAS  PubMed  Google Scholar 

  28. Reed BY, Heller HJ, Gitomer WL, Pak CY. Mapping a gene defect in absorptive hypercalciuria to chromosome 1q23.3-q24. J Clin Endocrinol Metab. 1999;84(11):3907–3913.

    Article  CAS  PubMed  Google Scholar 

  29. Odvina CV, Mason RP, Pak CY. Prevention of thiazide-induced hypokalemia without magnesium depletion by potassium-magnesium-citrate. Am J Ther. 2006;13(2):101–108.

    Article  PubMed  Google Scholar 

  30. Van Den Berg CJ, Kumar R, Wilson DM, Heath H 3rd, Smith LH. Orthophosphate therapy decreases urinary calcium excretion and serum 1, 25-dihydroxyvitamin D concentrations in idiopathic hypercalciuria. J Clin Endocrinol Metab. 1980;51(5):998–1001.

    Article  Google Scholar 

  31. Insogna KL, Ellison AS, Burtis WJ, Sartori L, Lang RL, Broadus AE. Trichlormethiazide and oral phosphate therapy in patients with absorptive hypercalciuria. J Urol. 1989;141(2):269–274.

    CAS  PubMed  Google Scholar 

  32. Breslau NA, Padalino P, Kok DJ, Kim YG, Pak CY. Physicochemical effects of a new slow-release potassium phosphate preparation (UroPhos-K) in absorptive hypercalciuria. J Bone Miner Res. 1995;10(3):394–400.

    Article  CAS  PubMed  Google Scholar 

  33. Pearle MS, Roehrborn CG, Pak CY. Meta-analysis of randomized trials for medical prevention of calcium oxalate nephrolithiasis. J Endourol. 1999;13(9):679–685.

    Article  CAS  PubMed  Google Scholar 

  34. Pak CY, Peterson R, Sakhaee K, Fuller C, Preminger G, Reisch J. Correction of hypocitraturia and prevention of stone formation by combined thiazide and potassium citrate therapy in thiazide-unresponsive hypercalciuric nephrolithiasis. Am J Med. 1985;79(3):284–288.

    Article  CAS  PubMed  Google Scholar 

  35. Pak CY, Sakhaee K, Fuller CJ. Physiological and physiochemical correction and prevention of calcium stone formation by potassium citrate therapy. Trans Assoc Am Physicians. 1983;96:294–305.

    CAS  PubMed  Google Scholar 

  36. Sakhaee K, Zisman A, Poindexter JR, Zerwekh JE, Pak CY. Metabolic effects of thiazide and 1, 25-(OH)2 vitamin D in postmenopausal osteoporosis. Osteoporos Int. 1993;3(4):209–214.

    Article  CAS  PubMed  Google Scholar 

  37. Sakhaee K, Harvey JA, Padalino PK, Whitson P, Pak CY. The potential role of salt abuse on the risk for kidney stone formation. J Urol. 1993;150(2 Pt 1):310–312.

    CAS  PubMed  Google Scholar 

  38. Pak CY, Moe OW, Sakhaee K, Peterson RD, Poindexter JR. Physicochemical metabolic characteristics for calcium oxalate stone formation in patients with gouty diathesis. J Urol. 2005;173(5):1606–1609.

    Article  CAS  PubMed  Google Scholar 

  39. Pak CY, Smith LH, Resnick MI, Weinerth JL. Dietary management of idiopathic calcium urolithiasis. J Urol. 1984;131(5):850–852.

    CAS  PubMed  Google Scholar 

  40. Preminger GM, Pak CY. The practical evaluation and selective medical management of nephrolithiasis. Semin Urol. 1985;3(3):170–184.

    CAS  PubMed  Google Scholar 

  41. Giannini S, Nobile M, Sartori L, et al. Bone density and skeletal metabolism are altered in idiopathic hypercalciuria. Clin Nephrol. 1998;50(2):94–100.

    CAS  PubMed  Google Scholar 

  42. Levine BS, Rodman JS, Wienerman S, Bockman RS, Lane JM, Chapman DS. Effect of calcium citrate supplementation on urinary calcium oxalate saturation in female stone formers: implications for prevention of osteoporosis. Am J Clin Nutr. 1994;60(4):592–596.

    CAS  PubMed  Google Scholar 

  43. Odvina CV, Poindexter JR, Peterson RD, Zerwekh JE, Pak CY. Intestinal hyperabsorption of calcium and low bone turnover in hypercalciuric postmenopausal osteoporosis. Urol Res. 2008;36(5):233–239.

    Article  CAS  PubMed  Google Scholar 

  44. Brenner B. Brenner and Rector’s The Kidney. Vol 1, 8th ed. Saunders: Elsevier; 2007

    Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Urology, The Warren School of Brown University, Rhode Island Hospital, Providence, RI, USA

    George E. Haleblian

Authors
  1. George E. Haleblian
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  2. Glenn M. Preminger
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Corresponding author

Correspondence to George E. Haleblian .

Editor information

Editors and Affiliations

  1. Dept. Urology, Spire Manchester Hospital, Russell Road, Manchester, M16 8AJ, United Kingdom

    Nagaraja P. Rao

  2. Division of Urologic Surgery, Duke University Medical Center, Durham, 27710, North Carolina, USA

    Glenn M. Preminger

  3. Department of Urology, South Manchester University Hospitals, Manchester, M20 2LR, United Kingdom

    John P. Kavanagh

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Haleblian, G.E., Preminger, G.M. (2010). Calcium Metabolism and Hypercalciuria. In: Rao, N., Preminger, G., Kavanagh, J. (eds) Urinary Tract Stone Disease. Springer, London. https://doi.org/10.1007/978-1-84800-362-0_12

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  • DOI: https://doi.org/10.1007/978-1-84800-362-0_12

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84800-361-3

  • Online ISBN: 978-1-84800-362-0

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