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Effect of supplemental calcium on serum and urinary calcium in osteoporotic patients
1Department of Endocrinology, Cleveland Clinic Foundation, OH 44195-5036.
Insights
Supplemental calcium (Ca) did not significantly increase urinary Ca levels in osteoporotic patients. Adding vitamin D also showed minimal impact on urinary Ca, suggesting limited effectiveness in older women.
Area of Science:
- Nephrology
- Endocrinology
- Geriatrics
Background:
- Osteoporosis management often involves calcium supplementation.
- Understanding calcium's effect on urinary and serum levels is crucial for patient care.
- The role of vitamin D in calcium metabolism warrants further investigation.
Purpose of the Study:
- To evaluate the impact of supplemental calcium on urinary and serum calcium in osteoporotic patients.
- To assess the influence of varying calcium intake levels on calcium excretion.
- To examine the combined effect of calcium and vitamin D supplementation on urinary calcium output.
Main Methods:
- Retrospective analysis of osteoporotic patient records.
- Comparison of serum and urinary calcium between calcium-supplemented and non-supplemented groups.
- Subgroup analysis based on daily calcium intake (low vs. high).
Main Results:
- No significant difference in serum calcium between supplemented and non-supplemented groups.
- Supplemental calcium did not lead to a significant increase in daily urinary calcium.
- Combined calcium and vitamin D supplementation showed a modest increase in urinary calcium.
Conclusions:
- Supplemental calcium does not appear to significantly elevate urinary calcium in osteoporotic women.
- Vitamin D supplementation has a limited effect on increasing urinary calcium in this population.
- Further research may be needed to optimize calcium and vitamin D regimens for osteoporosis.
Abstract:
A retrospective analysis of osteoporotic patient records was conducted to evaluate the effect of supplemental calcium (Ca) on urinary and serum Ca. Forty-seven patients composed the Ca-supplemented group and 17 patients the nonsupplemented group. Serum Ca values (mean +/- SD) were 9.3 +/- 0.3 and 9.4 +/- 0.4 mg/dl in the nonsupplemented and supplemented groups, respectively. Daily urinary Ca was 137 +/- 88 and 162 +/- 89 mg, respectively. Each group had similar concentrations of serum phosphorus, albumin and creatinine. Data from the Ca-supplemented group were divided into low and high Ca intake. In the low intake group (less than 1000 mg Ca/day), serum and urinary Ca were 9.4 +/- 0.4 and 166 +/- 88. In the high intake group (greater than 1000 mg/day), the values were 9.5 +/- 0.5 and 160 +/- 90, respectively. Seventeen and 36% of nonsupplemented and supplemented patients used estrogen, respectively. No significant effects of estrogen therapy were observed on serum or urinary Ca in either group. More detailed analysis of five patients was undertaken to evaluate the combined effect of supplemental vitamin D (ergocalciferol or calcitriol) and Ca on urinary Ca output. Baseline urinary Ca was 33 +/- 19 mg with an average daily Ca supplement of 1160 mg. After 4-8 weeks of supplemention with Ca and vitamin D, urinary Ca increased to only 68 +/- 33 mg. We conclude that supplemental Ca does not appear to cause a significant increase in urinary Ca and that added vitamin D has little effect on elevating urinary Ca in some older women.(ABSTRACT TRUNCATED AT 250 WORDS)