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Reduced Kidney Function and Relative Hypocalciuria-Observational, Cross-Sectional, Population-Based Data.

Massimo Cirillo1, Giancarlo Bilancio2, Pierpaolo Cavallo3,4

  • 1Department of Public Health, University of Naples Federico II, 80131 Naples (NA), Italy.

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|December 29, 2020
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Summary

Lower kidney function is linked to reduced urine calcium levels, primarily due to decreased glomerular filtration. In individuals with impaired kidney function, low urine calcium correlates with lower vitamin D levels.

Keywords:
1,25-dihydroxyvitamin DcalciumeGFRepidemiologykidney functionparathyroid hormone

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Area of Science:

  • Nephrology
  • Epidemiology
  • Metabolic Bone Disease

Background:

  • Kidney function significantly influences calcium homeostasis.
  • Urinary calcium excretion is a key indicator of calcium balance.
  • Understanding the relationship between kidney function and urine calcium is crucial for metabolic health.

Purpose of the Study:

  • To investigate the association between estimated glomerular filtration rate (eGFR) and urinary calcium levels in population-based samples.
  • To explore the relationship between reduced kidney function, urine calcium, and related metabolic parameters.

Main Methods:

  • Observational, cross-sectional epidemiological analysis of two adult cohorts (Gubbio and Moli-sani studies).
  • Assessment of kidney function using estimated glomerular filtration rate (eGFR).
  • Measurement of urinary calcium using calcium/creatinine ratio (Ca/Cr) in timed and spot urine samples.

Main Results:

  • eGFR showed a positive and independent association with Ca/Cr across different urine collection methods.
  • Lower eGFR was consistently related to lower Ca/Cr in both men and women.
  • Reduced eGFR was linked to lower glomerular filtered calcium load but not tubular calcium handling.
  • In subjects with reduced eGFR, low urine Ca/Cr was associated with low serum 1,25-dihydroxyvitamin D.

Conclusions:

  • Population-based data confirm that lower kidney function is associated with reduced urine calcium, mainly due to decreased glomerular filtration.
  • In individuals with impaired kidney function, relative hypocalciuria is linked to a higher prevalence of low serum 1,25-dihydroxyvitamin D.