Clinical Investigation

Kidney International (1982) 21, 90–97; doi:10.1038/ki.1982.13

Effects of calcitriol administration on calcium metabolism in healthy men

Nancy D Adams1, Richard W Gray1, Jacob Lemann Jr1 and Herman S Cheung1

1Departments of Medicine and Biochemistry and The Clinical Research Center, Medical College of Wisconsin, Milwaukee County Medical Complex, Milwaukee, Wisconsin

Correspondence: Dr N D Adams, Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78284, USA

Received 6 January 1981; Revised 17 July 1981.

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Abstract

Effects of calcitriol administration on calcium metabolism in healthy men. To evaluate the relationship between daily and fasting urinary calcium excretion and serum 1,25-(OH)2-D concentrations, we studied six healthy men during control and during chronic oral calcitriol administration (0.6, 1.2, or 1.8 nmoles every 6 hours for 6 to 12 days) while they ate normal and low calcium diets (calcium content, 19.2 or 4.2 mmoles/day). Daily urinary calcium excretion was directly related to serum 1,25-(OH)2-D concentrations but increased more (P < 0.025) while subjects ate the normal calcium diet (slope, 0.081 mmole/day/pmole/liter; r = 0.94) than when eating the low calcium diet (slope, 0.043 mmole/day/pmole/liter; r = 0.83). During calcitriol and ingestion of the low calcium diet, daily urinary calcium excretion averaged 7.32 plusminus 2.6 mmoles/day, exceeding the dietary calcium intake (P < 0.02). Moreover, during calcitriol, when serum 1,25-(OH)2-D exceeded 140 pmoles/liter, fasting urinary calcium/creatinine exceeded 0.34 mmole/mmole (the upper limit of normal) on either diet. When serum 1,25-(OH)2-D concentrations are elevated, a high fasting urinary calcium/creatinine or high daily urinary calcium excretion, even on a low calcium diet, is insufficient criteria for the documentation of a renal calcium leak.

Effets de l'administration de calcitriol sur le métabolisme du calcium chez hommes en bonne santé. Afin d'évaluer la relation entre l'excrétion urinaire quotidienne de calcium, l'excrétion de calcium à jeun et la concentration sérique de 1,25-(OH)2-D, nous avons étudié six hommes bien portants au cours de périodes contrôles et au cours de l'administration de calcitriol chronique par voie orale (0,6, 1,2, ou 1,8 nmoles chaque 6 heures pendant 6 à 12 jours) au cours de l'ingestion d'une alimentation normale ou pauvre en calcium (19,2 ou 4,2 mmoles de calcium par jour). L'excrétion urinaire de calcium quotidienne est directement liée à la concentration sérique de 1,25-(OH)2-D mais elle augmente plus (P < 0,025) quand les sujets ont une alimentation normale en calcium (pente 0,081 mmoles/jour par pmole par litre; r = 0,94) que lorsqu'ils ont une alimentation pauvre en calcium (pente 0,043 mmoles/jour par pmole par litre; r = 0,83). Au cours de l'ingestion de calcitriol et d'une alimentation pauvre en calcium, l'excrétion urinaire quotidienne de calcium est en moyenne de 7,32 plusminus 2,6 mmoles/jour, supérieure à l'ingestion de calcium (P < 0,02). De plus, au cours de l'ingestion de calcitriol, quand la concentration sérique de 1,25-(OH)2-D dépasse 140 pmole par litre, le rapport calcium/créatinine dans l'urine à jeun est supérieur à 0,34 (limite supérieure de la normale) quelle que soit l'alimentation. Quand les concentrations sériques de 1,25-(OH)2-D sont élevées, un rapport calcium/créatinine élevé dans l'urine ou une excrétion urinaire de 24 heures élevée sont insuffisants, même au cours d'une alimentation pauvre en calcium, pour établir l'existence d'une fuite rénale de calcium.

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