Dietary NaCl-restriction prevents the calciuria of KCl-deprivation and blunts the calciuria of KHCO3-deprivation in healthy adults.
Previous studies have demonstrated that dietary potassium deprivation in healthy human subjects eating diets otherwise containing normal quantities of NaCl is accompanied by an increase in urinary calcium excretion. This increase in urinary Ca excretion occurs in association with reductions in urinary Na and Cl excretion together with trends for weight gain and is delayed for several days after the initiation of K-deprivation, suggesting that it is mediated by NaCl retention and expansion of the extra-cellular volume. The present studies were thus undertaken to determine whether dietary NaCl restriction prevents the calciuric effect of subsequent K-deprivation. When dietary NaCl intake was limited to 5 +/- 3 mmol/day among 10 healthy adults, subsequent deprivation of KCl (-67 mmol/day) in 5 subjects of deprivation of KHCO3 (-64 mmol/day) in 5 subjects prevented any significant increase in daily urinary Ca excretion during five days of K-deprivation. There was, however, a small but significant cumulative increase above control in urinary Ca excretion at the end of KHCO3-deprivation, averaging + 1.9 +/- 0.6 mmol; P < 0.05. When KCl was restored to the diets urinary Ca excretion increased while restoration of KHCO3 to the diets caused urinary Ca to fall to rates below control. We conclude that the calciuria of K-deprivation when NaCl is present in the diet is largely dependent upon NaCl retention by the kidneys and subsequent ECF-volume expansion. In addition, HCO3 is anti-calciuric.
Lemann
J
J
Department of Medicine, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee, USA.
Pleuss
J A
JA
Hornick
L
L
Hoffman
R G
RG
D000284:Administration, Oral; D000328:Adult; D001639:Bicarbonates / Q000494:pharmacology*; D002118:Calcium / Q000097:blood / Q000652:urine*; D002712:Chlorides / Q000097:blood / Q000652:urine; D004039:Diet, Sodium-Restricted; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000378:metabolism*; D008274:Magnesium / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood / Q000652:urine; D011189:Potassium Chloride / Q000494:pharmacology*; D017680:Potassium Compounds / Q000494:pharmacology*; D012964:Sodium / Q000097:blood / Q000652:urine
D001639:Bicarbonates; D002712:Chlorides; D010710:Phosphates; D017680:Potassium Compounds; D011189:Potassium Chloride; D012964:Sodium; C026329:potassium bicarbonate; D008274:Magnesium; D002118:Calcium