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Acetate and hypercalciuria during total parenteral nutrition
C H Berkelhammer1, R J Wood, M D Sitrin
1Department of Medicine, University of Chicago, IL.
The American Journal of Clinical Nutrition
|December 1, 1988
Summary
Supplementing total parenteral nutrition (TPN) with acetate reduces urinary calcium excretion and improves calcium balance. This acetate supplementation helps mitigate hypercalciuria, a common complication of TPN.
Area of Science:
- Nephrology
- Nutritional Science
- Metabolic Disorders
Background:
- Hypercalciuria and negative calcium balance are known complications of total parenteral nutrition (TPN).
- The acid load generated from TPN formula metabolism can contribute to hypercalciuria.
Purpose of the Study:
- To evaluate the effect of supplementing TPN formulas with acetate on calcium balance and excretion.
- To determine if acetate supplementation can mitigate TPN-induced hypercalciuria.
Main Methods:
- A randomized crossover study involving patients on continuous and cyclic TPN.
- Patients received TPN with or without added acetate (160 mmol/d, replacing chloride) for 3 days each.
- Blood and urine parameters, including urinary calcium, were measured on day 3 of each treatment period.
Main Results:
- Acetate supplementation increased blood pH and decreased renal acid excretion.
- Urinary calcium excretion significantly decreased in all patients during both continuous and cyclic TPN with acetate.
- Acetate led to a slight decrease in filtered calcium load but a significant increase in renal tubular calcium reabsorption.
Conclusions:
- Acetate supplementation is effective in reducing urinary calcium excretion in patients receiving TPN.
- Acetate addition to TPN formulas may help correct negative calcium balance and prevent hypercalciuria.