Diet and Calcium: The End of an Era
Authors: Fredric L. Coe
Journal: Annals of Internal Medicine (1997)

Editorials1 April 1997Diet and Calcium: The End of an EraFredric L. Coe, MD, Joan H. Parks, MBA, and Murray J. Favus, MDFredric L. Coe, MDUniversity of Chicago Medical School, Chicago, IL 60637, Joan H. Parks, MBAUniversity of Chicago Medical School, Chicago, IL 60637, and Murray J. Favus, MDUniversity of Chicago Medical School, Chicago, IL 60637Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-7-199704010-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Because the main constituents of most human kidney stones are calcium salts, intuition has always linked stone formation to levels of urinary calcium. The discovery by Flocks [1] of otherwise asymptomatic hypercalciuria (so-called idiopathic hypercalciuria) in a majority of stone formers made this association more compelling. Since at least 1936, idiopathic hypercalciuria has been a recognized clinical diagnosis that affects upward of 70% of patients who make calcium-containing stones [2]. Naturally, clinical belief would presume that decreasing urinary calcium levels should reduce stone formation, and this belief has translated itself into several therapeutic actions.An abnormally efficient intestinal absorption of ...References1. Flocks RH. Calcium and phosphorus excretion in the urine of patients with renal or ureteral calculi. JAMA. 1939; 113:1466. Google Scholar2. Coe FL, Parks JH, Asplin JR. The pathogenesis and treatment of kidney stones. N Engl J Med. 1992; 327:1141-52. Google Scholar3. Lemann JJ. Calcium and phosphate metabolism: an overview in health and in calcium stone formers. In: Coe FL, Favus MJ, Pak CY, Parks JH, Preminger GM, eds. Kidney Stones: Medical and Surgical Management. Philadelphia: Lippincott-Raven; 1996:259-88. Google Scholar4. Broadus AE, Insogna KL, Lang R, Ellison AF, Dreyer BE. Evidence for disordered control of 1,25 dihydroxyvitamin D production in absorptive hypercalciuria. N Engl J Med. 1984; 311:73-80. Google Scholar5. Pak CY. Medical management of nephrolithiasis. J Urol. 1982; 128:11157-64. Google Scholar6. Hosking DH, Erickson SB, Van den Berg CJ, Wilson DM, Smith LH. The stone clinic effect in patients with idiopathic calcium urolithiasis. J Urol. 1983; 130:1115-8. Google Scholar7. Ettinger B, Citron JT, Livermore B, Dolman LI. Chlorthalidone reduces calcium oxalate calculous recurrence but magnesium hydroxide does not. J Urol. 1988; 139:679-84. Google Scholar8. Asplin JR, Favus MJ, Coe FL. Nephrolithiasis. In: Brenner BM, ed. Brenner and Rector's The Kidney. 5th ed. Philadelphia: WB Saunders; 1996:1893-935. Google Scholar9. Coe FL, Favus MJ, Crockett T, Strauss AL, Parks JH, Porat A, et al. Effects of low-calcium diet on urine calcium excretion, parathyroid function and serum 1,25(OH)2D3 levels in patients with idiopathic hypercalciuria and in normal subjects. Am J Med. 1982; 72:25-32. Google Scholar10. Maierhofer WJ, Lemann J Jr, Gray RW, Cheung HS. Dietary calcium and serum 1,25-(OH)2-vitamin D concentrations as determinants of calcium balance in healthy men. Kidney Int. 1984; 26:752-9. Google Scholar11. Jaeger P, Portmann L, Jacquet AF, Burckhardt P. Influence of the calcium content of the diet on the incidence of mild hyperoxaluria in idiopathic renal stone formers. Am J Nephrol. 1985; 5:40-4. Google Scholar12. Hayashi Y, Kaplan RA, Pak CY. Effect of sodium cellulose phosphate therapy on crystallization of calcium oxalate in urine. Metabolism. 1975; 24:1273-8. Google Scholar13. Bataille P, Achard JM, Fournier A, Boudailliez B, Westeel PF, el Esper N, et al. Diet, vitamin D and vertebral mineral density in hypercalciuric calcium stone formers. Kidney Int. 1991; 39:1193-205. Google Scholar14. Curhan GC, Willett WC, Speizer FE, Spiegelman D, Stampfer MJ. Comparison of dietary with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Ann Intern Med. 1997; 126:497-504. Google Scholar15. Curhan GC, Willett WC, Rimm EB, Stampfer MJ. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med. 1993; 328:833-8. Google Scholar16. Coe FL, Parks JH, Bushinsky DA, Langman CB, Favus MJ. Chlorthalidone promotes mineral retention in patients with idiopathic hypercalciuria. Kidney Int. 1988; 33:1140-6. Google Scholar17. Wasnich RD, Benfante RJ, Yano K, Heilbrun L, Vogel JM. Thiazide effect on the mineral content of bone. N Engl J Med. 1983; 309:344-7. Google Scholar18. LaCroix AZ, Wienpahl J, White LR, Wallace RB, Scherr PA, George LK, et al. Thiazide diuretic agents and the incidence of hip fracture. N Engl J Med. 1990; 322:286-90. Google Scholar19. Heidrich FE, Stergachis A, Gross KM. Diuretic drug use and risk for hip fracture. Ann Intern Med. 1991; 115:1-6. Google Scholar20. Aubin R, Menard P, Lajeunesse D. Selective effect of thiazides on the human osteoblast-like cell line MG-63. Kidney Int. 1996; 50:1476-82. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Chicago Medical School, Chicago, IL 60637Grant Support: By a George M. O'Brien Center of Excellence Grant DK47631, from the National Institute of Diabetes and Digestive and Kidney Diseases.Corresponding Author: Fredric L. Coe, MD, Renal Section, MC 5100, University of Chicago Medical School, 5841 South Maryland Avenue, Chicago, IL 60637.Current Author Addresses: Drs. Coe and Favus and Ms. Parks: University of Chicago Medical School, 5841 South Maryland Avenue, Chicago, IL 60637.Grant Support: By a George M. O'Brien Center of Excellence Grant DK47631, from the National Institute of Diabetes and Digestive and Kidney Diseases.Corresponding Author: Fredric L. Coe, MD, Renal Section, MC 5100, University of Chicago Medical School, 5841 South Maryland Avenue, Chicago, IL 60637.Current Author Addresses: Drs. Coe and Favus and Ms. Parks: University of Chicago Medical School, 5841 South Maryland Avenue, Chicago, IL 60637. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparison of Dietary Calcium with Supplemental Calcium and Other Nutrients as Factors Affecting the Risk for Kidney Stones in Women Gary C. Curhan , Walter C. Willett , Frank E. Speizer , Donna Spiegelman , and Meir J. Stampfer Metrics Cited ByNutrition Therapy for Specific Lithogenic Risk Factors: High Urine Calcium, High Urine OxalateNutritional Prevention and Treatment of Kidney StonesCalcium Supplementation and Incident Kidney Stone Risk: A Systematic ReviewThe Health Benefits of Calcium Citrate Malate: A Review of the Supporting ScienceAssociation of Vitamin D Receptor-Gene ( FokI ) Polymorphism with Calcium Oxalate NephrolithiasisMaternal Calcium Intake and Offspring Blood PressureBone Mineral Density and Biochemical Markers of Bone in Patients With Idiopathic HypercalciuriaStudies on the Chemical Composition and Presentation of Urinary Stones in relation to Sex and Age among Human Population of Multan, PakistanUrinary CalculiEDITORIAL: SOMETHING NEW ABOUT STONESNo Association of Vitamin D Receptor Gene Bsm I Polymorphisms with Calcium Oxalate Stone FormationUrolithiasis—Patient Evaluation and Medical TreatmentNew Insights into Causes and Treatments of Kidney StonesMedical Therapy for UrolithiasisMetabolic Evaluation of Stone Disease Patients: A Practical ApproachDairy Foods and OsteoporosisEssential arterial hypertension and stone diseaseDIVERGENCE BETWEEN STONE COMPOSITION AND URINE SUPERSATURATION: CLINICAL AND LABORATORY IMPLICATIONSDIVERGENCE BETWEEN STONE COMPOSITION AND URINE SUPERSATURATIONAuthors' reply:Risico op nierstenen bij vrouwen. De invloed van calcium in de voeding, calcium als supplement en andere voedingsbestanddelenMinerals in animals and vegetables 1 April 1997Volume 126, Issue 7Page: 553-555KeywordsBoneBone densityCalciumDietExcretionSaltsSarcoidosisSodiumUrineVitamin D Issue Published: 1 April 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...