Effect of acute acid loading on acid–base and calcium metabolism

Osther, Palle Jørn Sloth

doi:10.1080/00365590500368344

Cited by 14 publications

(8 citation statements)

References 34 publications

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“…This rise in serum calcium was blunted with pharmacological inhibition of cell‐mediated bone resorption (using colchicine or calcitonin), supporting the notion that bone matrix is actively degraded in response to an acid load. A randomized trial by Osther 99 also observed increasing ionized calcium in serum in response to acute acid loading. This effect has been reported in one trial of high protein intake 22 ; however, most studies have not seen a change in serum calcium with high protein intakes 53,66,100 …”

Section: Protein and Bonementioning

confidence: 92%

Dietary protein and bone health: harmonizing conflicting theories

Thorpe

Evans

2011

Nutrition Reviews

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No clear consensus on the role of higher protein intakes has emerged, in spite of many decades of research. Protein unambiguously increases urinary calcium losses, which is completely attributable to the dietary acid load imposed by metabolism of sulfur containing amino acids into acid equivalents. Although alternate dietary sources of fixed acid cause demineralization of bone and apparent osteoporosis, this effect has not been consistently observed for protein, suggesting opposing, beneficial effects on bone. Specifically, protein may improve bone health through improving calcium absorption, increasing total circulating insulin-like growth factor 1 or by improving lean body mass which in turn increases bone growth. Although the notion of competing positive and negative pathways has been articulated theoretically, statistical mediation models of this "dual pathways" relationship have not been employed to quantify these relationships.In a cross-sectional investigation of postmenopausal women, protein intake is positively related to bone mineral density of the lumbar spine following adjustment for an accompanying negative effect mediated by the sulfur containing fraction of protein. In growing rats, an analogous and complementary pattern emerged: A negative association of protein intake with bone strength was suppressed by an opposing, positive effect of protein mediated by insulin-like growth factor 1. A second animal study assessed the influence of protein source on bone strength and bone mineral content of growing rats consuming isoenergetic, isonitrogenous diets. The influence of protein source was completely mediated by the corresponding changes in lean body mass.ii iii A randomized, controlled trial indicated a higher protein diet preserved bone density during weight loss compared to a conventional, MyPyramid based diet; however the protein diet also contained more calcium. A mathematical model of calcium availability in this trial suggested that this additional dietary calcium was not sufficient to explain differences in calcium accrual between groups unless calcium availability was also improved in the higher protein diet. Also, within this study, urine calcium (a surrogate of the diet acid load) exhibited a negative association with bone density change, in spite of its positive association with protein intake.The striking consistency of a dual pathway model across populations and experimental models lends credence to the notion that dietary protein may hold a positive or negative effect on bone health, depending on other factors in the diet. Specifically, we find support that the sulfur containing amino acid induced dietary acid load holds negative effects that may be opposed by positive influences of insulin-like growth factor 1, calcium availability or lean body mass. On average, this effect is probably null or too small to be of clinical importance.The effect may be of public health relevance, however, if the diet can be manipulated in order to uncouple positive and negative pathways. If correc...

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Section: Protein and Bonementioning

confidence: 92%

Dietary protein and bone health: harmonizing conflicting theories

Thorpe

Evans

2011

Nutrition Reviews

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“…This acid load unequivocally has been shown to result in increased renal excretion rates of calcium and decreased urinary excretion of citrate. 35 From a pathophysiological point of view, this combination may result in an increased risk of calcium salt crystallization in the urine. In a recent case-control study, 123 renal calcium stone formers were compared with age-and sex-matched controls with regard to the potential renal acid load calculated from dietary records.…”

Section: Dietary Salt and Hypertensionmentioning

confidence: 99%

“…Data in the literature suggest that individuals forming calcium containing stones in the kidney may be more sensitive to such an acid load, potentially tilting the subtle balance in urine toward crystallization. 35 Furthermore, the low urine pH resulting from animal protein loads potentially may increase risk of uric acid stone formation. This may be especially important in individuals with insulin resistance that results in reduced ammoniagenesis and persistent acid urine, which has been shown to be closely associated with uric acid nephrolithiasis.…”

Section: Dietary Salt and Hypertensionmentioning

confidence: 99%

High-Protein Diets and Renal Health

Marckmann

Osther

Pedersen

et al. 2015

Journal of Renal Nutrition

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“…This is a risk factor for the development of uric acid stones and may play a role in calcium stone formation. (5) Chronic metabolic acidosis induced by the increased acid load decreases calcium reabsorption within the nephron [85–87]. (6) The decreased urinary pH may potentiate uric acid lithiasis, and it enhances citrate reabsorption in the proximal tubules, thus decreasing the excretion of this important inhibitor of crystallization [88].…”

Section: Differences In Epidemiologymentioning

confidence: 99%

History, epidemiology and regional diversities of urolithiasis

2010

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Archeological findings give profound evidence that humans have suffered from kidney and bladder stones for centuries. Bladder stones were more prevalent during older ages, but kidney stones became more prevalent during the past 100 years, at least in the more developed countries. Also, treatment options and conservative measures, as well as 'surgical' interventions have also been known for a long time. Our current preventive measures are definitively comparable to those of our predecessors. Stone removal, first lithotomy for bladder stones, followed by transurethral methods, was definitively painful and had severe side effects. Then, as now, the incidence of urolithiasis in a given population was dependent on the geographic area, racial distribution, socio-economic status and dietary habits. Changes in the latter factors during the past decades have affected the incidence and also the site and chemical composition of calculi, with calcium oxalate stones being now the most prevalent. Major differences in frequency of other constituents, particularly uric acid and struvite, reflect eating habits and infection risk factors specific to certain populations. Extensive epidemiological observations have emphasized the importance of nutritional factors in the pathogenesis of urolithiasis, and specific dietary advice is, nowadays, often the most appropriate for prevention and treatment of urolithiasis.

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Effect of acute acid loading on acid–base and calcium metabolism

Cited by 14 publications

References 34 publications

Dietary protein and bone health: harmonizing conflicting theories

Dietary protein and bone health: harmonizing conflicting theories

High-Protein Diets and Renal Health

History, epidemiology and regional diversities of urolithiasis

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