Evidence for disordered acid-base handling in calcium stone-forming patients
| Autor: | Elaine M. Worcester, Daniel L. Gillen, Kristin J. Bergsland, Fredric L. Coe |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Calcium Phosphates Male musculoskeletal diseases medicine.medical_specialty Base (chemistry) Physiology Idiopathic hypercalciuria Hypercalciuria 030232 urology & nephrology Calcium oxalate chemistry.chemical_element Urine Acid-Base Imbalance 030204 cardiovascular system & hematology Calcium Citric Acid Kidney Tubules Proximal Kidney Calculi Young Adult 03 medical and health sciences chemistry.chemical_compound Sex Factors fluids and secretions 0302 clinical medicine Risk Factors Internal medicine Ammonium Compounds medicine Humans Acid-Base Equilibrium chemistry.chemical_classification Calcium Oxalate Calcium stone Hydrogen-Ion Concentration Middle Aged medicine.disease Diet Endocrinology chemistry Gastrointestinal Absorption Case-Control Studies Female Kidney stones Stone formers Crystallization Biomarkers |
| Zdroj: | American Journal of Physiology-Renal Physiology. 318:F363-F374 |
| ISSN: | 1522-1466 1931-857X |
| DOI: | 10.1152/ajprenal.00400.2019 |
| Popis: | In stone formers (SFs) with idiopathic hypercalciuria, urine pH governs the mineral phase of stones. Calcium phosphate (CaP) SFs have higher urine pH than calcium oxalate (CaOx) SFs. Normal women have higher urine pH than men on fixed diets, accompanied by greater absorption of food alkali. Female CaP and male CaOx SFs have similar urine pH as same sex normal individuals, but male CaP and female CaOx SFs may have abnormal acid-base handling. We studied 25 normal individuals (13 men and 12 women), 17 CaOx SFs (11 men and 6 women), and 15 CaP SFs (8 men and 7 women) on fixed diets. Urine and blood samples were collected under fasting and fed conditions. Female CaOx SFs had lower urine pH and lower alkali absorption, fed, compared with normal women; their urine NH4 was higher and urine citrate excretion lower than in normal women, consistent with their higher net acid excretion. Male CaOx SFs had higher urine citrate excretion and higher serum ultrafilterable citrate levels than normal men. Both male and female CaP SFs had higher urine pH fasting than same sex normal individuals, but only men were higher in the fed period, and there were no differences from normal in gut alkali absorption. CaP SFs of both sexes had higher urine NH4 and lower urine citrate than same sex normal individuals. The lower urine pH of female CaOx SFs seems related to decreased gut alkali absorption, while the higher pH of CaP SFs, accompanied by higher urine NH4 and lower urine citrate, suggests a proximal tubule disorder. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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