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Research Article Free access | 10.1172/JCI105530

The Effect of Treatment of Acidosis on Calcium Balance in Patients with Chronic Azotemic Renal Disease

John R. Litzow, Jacob Lemann Jr., and Edward J. Lennon

Department of Internal Medicine and the Clinical Research Center, Marquette University School of Medicine, and the Milwaukee County General Hospital, Milwaukee, Wise.

†

Trainee in the Dept. of Medicine, Marquette University School of Medicine, and supported by U. S. Public Health Service training grant 2 T1 AM5023 (e).

‡

Address requests for reprints to Dr. Edward J. Lennon, Milwaukee County General Hospital, 8700 Wisconsin Ave., Milwaukee, Wise. 53226.

*

Submitted for publication April 11, 1966; accepted October 31, 1966.

This investigation was supported in part by research grants RO1 AM 08924 and 5 MO1 FR-00058, both from the U. S. Public Health Service.

Presented in part before the Thirty-ninth Annual Meeting of the Central Society for Clinical Research, November 1966, Chicago, Ill.

Find articles by Litzow, J. in: PubMed | Google Scholar

Department of Internal Medicine and the Clinical Research Center, Marquette University School of Medicine, and the Milwaukee County General Hospital, Milwaukee, Wise.

†

Trainee in the Dept. of Medicine, Marquette University School of Medicine, and supported by U. S. Public Health Service training grant 2 T1 AM5023 (e).

‡

Address requests for reprints to Dr. Edward J. Lennon, Milwaukee County General Hospital, 8700 Wisconsin Ave., Milwaukee, Wise. 53226.

*

Submitted for publication April 11, 1966; accepted October 31, 1966.

This investigation was supported in part by research grants RO1 AM 08924 and 5 MO1 FR-00058, both from the U. S. Public Health Service.

Presented in part before the Thirty-ninth Annual Meeting of the Central Society for Clinical Research, November 1966, Chicago, Ill.

Find articles by Lemann, J. in: PubMed | Google Scholar

Department of Internal Medicine and the Clinical Research Center, Marquette University School of Medicine, and the Milwaukee County General Hospital, Milwaukee, Wise.

†

Trainee in the Dept. of Medicine, Marquette University School of Medicine, and supported by U. S. Public Health Service training grant 2 T1 AM5023 (e).

‡

Address requests for reprints to Dr. Edward J. Lennon, Milwaukee County General Hospital, 8700 Wisconsin Ave., Milwaukee, Wise. 53226.

*

Submitted for publication April 11, 1966; accepted October 31, 1966.

This investigation was supported in part by research grants RO1 AM 08924 and 5 MO1 FR-00058, both from the U. S. Public Health Service.

Presented in part before the Thirty-ninth Annual Meeting of the Central Society for Clinical Research, November 1966, Chicago, Ill.

Find articles by Lennon, E. in: PubMed | Google Scholar

Published February 1, 1967 - More info

Published in Volume 46, Issue 2 on February 1, 1967
J Clin Invest. 1967;46(2):280–286. https://doi.org/10.1172/JCI105530.
© 1967 The American Society for Clinical Investigation
Published February 1, 1967 - Version history
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Abstract

Small but statistically significant negative calcium balances were found in each of eight studies in seven patients with chronic azotemic renal disease when stable metabolic acidosis was present. Only small quantities of calcium were excreted in the urine, but fecal calcium excretion equaled or exceeded dietary intake. Complete and continuous correction of acidosis by NaHCO3 therapy reduced both urinary and fecal calcium excretion and produced a daily calcium balance indistinguishable from zero.

Apparent acid retention was found throughout the studies during acidosis, despite no further reduction of the serum bicarbonate concentration. The negative calcium balances that accompanied acid retention support the suggestion that slow titration of alkaline bone salts provides an additional buffer reservoir in chronic metabolic acidosis. The treatment of metabolic acidosis prevented further calcium losses but did not induce net calcium retention. It is suggested that the normal homeostatic responses of the body to the alterations in ionized calcium and calcium distribution produced by raising the serum bicarbonate might paradoxically retard the repair of skeletal calcium deficits.

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