Effect of Frusemide on Calcium Excretion

After giving oral frusemide (Lasix) to 14 normal volunteers significant hypercalciuria occurred in all of them. This could not be accounted for by any change in glomerular filtration rate, but was possibly due to decreased tubular reabsorption.     

Urinary Excretion of Calcium and Citrate in Normal Individuals and Stone Formers with Variation in Calcium Intake

The changes which occur in both calcium and citrate excretion in normal persons, in idiopathic calcium stone formers and in persons with hyperparathyroidism have been measured at high and low levels of dietary calcium intake. The findings suggested a difference in the renal handling of calcium between normal subjects and stone formers. There was a greater increase in the urinary excretion of calcium with increased intake of calcium in individuals with renal calculi than in normals. Increasing the calcium intake shifted the mole ratio of calcium to citrate unfavourably for the chelation of calcium by citrate, and this unfavourable shift was more marked in the stone formers than in normal individuals. These findings support the concept that urinary citrate may be of importance in the prevention of calcium precipitation and hence in the pathogenesis of kidney stones.     

Effect of Frusemide Administration on Calcium Excretion

Each of eight adipose but otherwise normal patients on a reducing diet received daily oral doses of frusemide for four days; the degree of hypercalciuria was found to be significant during the first three days, but on day four the calcium excretion in the urine had become normal though frusemide was still being given. The rates of excretion of sodium and calcium in the urine were closely correlated.     

Effect of Hydrochlorothiazide on Serum and Urinary Calcium and Urinary Citrate

Benzothiadiazines, potent oral diuretics, also inhibit carbonic anhydrase, although to a lesser degree than acetazolamide (Diamox). The latter has little effect on urinary calcium but causes hypocitriuria which predisposes to nephrolithiasis. The effect of benzothiadiazines on urinary calcium/citrate balance is less well known. In this study, the fall of urinary calcium and citrate was roughly 50% and 30%, respectively, in normal and hypertensive subjects during the prolonged administration of hydrochlorothiazide, a member of the benzothiadiazine family. Hence, in contradistinction to acetazolamide, this drug produces hypocalciuria but depresses the urinary citrate less. Consequently, the benzothiadiazines would not be expected to predispose to nephrolithiasis. In addition, hydrochlorothiazide was found to produce a 10-20% fall in creatinine clearance and an initial rise of roughly 0.7 mg./100 ml. in serum calcium concentration. There are indications that the benzothiadiazines affect the overall metabolism of calcium and citrate.     

Effect of Late Night Calcium Supplements on Overnight Urinary Calcium Excretion in Premenopausal and Postmenopausal Women

The overnight urinary calcium/creatinine ratio is higher in the early years after the menopause than before it. However, the increment of urinary calcium/creatinine after a late evening calcium supplement is less in early postmenopausal than in premenopausal women. It is suggested that calcium therapy in postmenopausal osteoporosis may be best administered as a single late evening dose rather than in divided doses throughout the day.     

Effect of Pregnancy on Sebum Excretion

Sebum excretion rates from forehead skin were measured serially during and after pregnancy in 10 normal women. Only minor fluctuations occurred during the middle and last trimesters of pregnancy, but there was a pronounced decrease in the postpartum period. Probably a powerful sebotrophic factor is present in pregnancy, but its nature is conjectural.     

Effect of Acetazolamide on Obesity-Induced Glomerular Hyperfiltration: A Randomized Controlled Trial

Aims

Obesity is an important risk factor for the development of chronic kidney disease. One of the major factors involved in the pathogenesis of obesity-associated kidney disease is glomerular hyperfiltration. Increasing salt-delivery to the macula densa is expected to decrease glomerular filtration rate (GFR) by activating tubuloglomerular feedback. Acetazolamide, a carbonic anhydrase inhibitor which inhibits salt reabsorption in the proximal tubule, increases distal salt delivery. Its effects on obesity-related glomerular hyperfiltration have not previously been studied. The aim of this investigation was to evaluate whether administration of acetazolamide to obese non diabetic subjects reduces glomerular hyperfiltration.

Materials and Methods

The study was performed using a randomized double-blind crossover design. Obese non-diabetic men with glomerular hyperfiltration were randomized to receive intravenously either acetazolamide or furosemide at equipotent doses. Twelve subjects received the allocated medications. Two weeks later, the same subjects received the drug which they had not received during the first study. Inulin clearance, p-aminohippuric acid clearance and fractional lithium excretion were measured before and after medications administration. The primary end point was a decrease in GFR, measured as inulin clearance.

Results

GFR decreased by 21% following acetazolamide and did not decrease following furosemide. Renal vascular resistance increased by 12% following acetazolamide, while it remained unchanged following furosemide administration. Natriuresis increased similarly following acetazolamide and furosemide administration. Sodium balance was similar in both groups.

Conclusions

Intravenous acetazolamide decreased GFR in obese non-diabetic men with glomerular hyperfiltration. Furosemide, administered at equipotent dose, did not affect GFR, suggesting that acetazolamide reduced glomerular hyperfiltration by activating tubuloglomerular feedback.

Trial Registration

ClinicalTrials.gov NCT01146288     

Magnesium,Calcium, and Trace Elements Excretion in 24-h Urine

Urine is a clinical specimen often used in medical diagnostics for monitoring of elements concentrations and kidneys function. We determined the contents of magnesium (Mg), calcium (Ca), zinc (Zn), copper (Cu), iron (Fe), lead (Pb), and cadmium (Cd) in 74 samples of 24-h urine (from 46 women and 28 men). The measurements were realized by the atomic absorption spectrometry (AAS) with atomization in the flame (FAAS) and in the graphite furnace (GFAAS). The received results were the subject of statistical analysis including the sex and age of volunteers. Moreover, correlations between the elements and the relationships between age and amounts of excreted elements with urine were tested. We found the statistically significant higher content of Zn in men’s urine than in women^’s one. Moreover, both adult women and men (>18 years) excreted much more Ca in urine in comparison to young subjects. Only in case of Pb the significant positive correlation between its amount in 24-h urine of all donors and age was stated. The correlation analysis has shown the significant positive relationships between Ca–Mg, Ca–Fe, Mg–Fe, Cu–Fe, Cu–Cd, Fe–Cd, and Pb–Cd in total samples of urine. Basing on our results, we concluded that the gender and age of donors may impact on the elemental status of 24-h urine.     

Effect of Combination Therapy with a Calcium Channel Blocker and an Angiotensin-Converting Enzyme Inhibitor on Renal Hypertrophy and Urinary Albumin Excretion in Diabetic Rats

The objective of this study was to compare the effect of an angiotensin-converting enzyme (ACE) inhibitor and a calcium channel blocker on the development of renal changes in diabetic rats. Diabetes was induced by an intravenous injection of streptozotocin in normotensive Wistar rats. Treatment was commenced immediately in 1 set of rats with 4 treatment arms: nitrendipine (250 mg/kg fodder), enalapril (35 mg/L drinking water), both treatments in combination, or placebo. Treatment was continued for 9 weeks. Another set of rats was left with untreated diabetes for 3 months followed by 7 weeks treatment as above. When starting treatment right after induction of diabetes, nitrendipine significantly reduced urinary albumin excretion (UAE) to the nondiabetic level (P < .05) without reducing blood pressure (BP), whereas enalapril failed to significantly reduce UAE despite a reduction in BP. Combining the two treatments showed no further reduction in UAE compared to monotherapy with nitrendipine, despite a lower BP. When leaving diabetic rats untreated for 3 months, only the coadministration of nitrendipine and enalapril showed a significant reduction in UAE compared to monotherapy and placebo treatment, but showed no significant effect on BP.     

Seasonal Variation in Urinary Excretion of Calcium, Magnesium and Phosphate in Manic-Melancholic Patients

The 24-hr urinary excretion of calcium, magnesium and phosphate was measured in 76 normal control persons, 95 manic-melancholic patients not on lithium treatment and 74 lithium-treated manic-melancholic patients. The mean value of the urinary excretion for each of the four seasons during a 5-year period was calculated. The normal control persons had a higher excretion of calcium during the summer months than during the rest of the year; this seasonal variation was not present in the two groups of manic-melancholic patients.

Previously reported changes in electrolyte metabolism during lithium treatment were confirmed, but some of the results varied with the season.     

Comparative Study on the Effect of Variable Phosphorus Intake at two Different Calcium Levels on P Excretion and P Flow at the Terminal Ileum of Laying Hens

A 3 ‐ 2-factorial balance trial was conducted with dietary concentrations of P below the requirement (3.6, 4.3 and 5.0g/kg DM) and Ca below or at the requirement (28 and 37g/kg DM) adjusted by monobasic calcium phosphate (MCP, Ca(H₂PO₄)₂) and calcium carbonate (CaCO₃). The diets were mainly based on maize and soybean meal. Six 18-week old laying hens were allocated to each of the diets, and excreta were quantitatively collected for 21 days from week 22 of age onwards. Feed allowance was 95 g/d according to pre-treatment ad libitum intake of the hens receiving the lowest P concentration. After the balance trial was terminated, ileal digesta was obtained from each hen, and the flow at the terminal ileum was calculated using TiO₂ as indigestible marker. Linear regression analysis was applied to determine the effect of supplementary P. Hens were in a negative energy balance, indicated by a loss in BW across all treatments. Intake and excretion of both N and energy were not significantly affected by the P or Ca content of the diet. P from supplemented MCP was almost completely recovered in excreta, irrespective of dietary Ca concentration. At the terminal ileum, however, the P flow was not significantly affected by the MCP supplementation. Net absorption of P from MCP was almost complete until the terminal ileum, but P was re-directed into the excreta, likewise via the urine. The supplementation of Ca reduced praecaecal net absorption and utilisation of P from the basal diet, likewise due to a reduced phytate hydrolysis. It is suggested by the data, that comparative measurements of P availability for laying hens should be conducted on the basis of praecaecal net absorption rather than on total excretion measurements.     

Effect of Penicillamine in Promoting Lead Excretion

A spectrochemical study of the urine and blood of 14 subjects exposed to lead in their work for several years, but without obvious signs of intoxication, was carried out to determine the porphyrin and lead content before and after a provocative dose of 0.9 g. penicillamine, administered on a single day.The average total urinary porphyrin excretion before administration of penicillamine was 0.506 mg. per litre (normal value = 0.274), and after penicillamine administration 0.386 mg. per litre (normal value = 0.274). The average lead excretion before administration of penicillamine was less than 0.013 mg. per litre (normal value = 0.031) and after administration of penicillamine 0.367 mg. per litre (normal value = 0.047).The average erythrocyte porphyrin content was 76.8 μg. % before and 76.95 μg. % after administration of penicillamine—values approximately thrice normal. Blood lead content before administration of penicillamine averaged 7.61 μg. % and after penicillamine 5.68 μg. %.Lead excretion in exposed persons before penicillamine administration was less than in apparently normal persons, while porphyrin levels were higher. The effect of penicillamine is shown by a definite increase in lead excretion (average = 0.406 mg. lead per gram penicillamine administered) and a decrease in porphyrin excretion in the 14 subjects.     

The Effect of Methandrostenolone on Nitrogen Excretion Following Open-Heart Surgery

An attempt was made to assess the effect of an anabolic hormone in the postoperative phase. Methandrostenolone (Danabol) was given to groups of adults and children undergoing open-heart surgery, and the results were compared with those obtained in control groups. No difference in the clinical picture could be found between the treated and the untreated groups, or in the total amount of nitrogen excreted during six days following the operation. In both treated groups the urinary volume was increased, resulting in a decreased urinary nitrogen concentration.