Study of intestinal absorption of calcium in patients with renal failure

Coburn, Jack W.; Koppel, Marcelo H.; Brickman, Arnold S.; Massry, Shaul G.
January 1973
Kidney International;Jan1973, Vol. 3 Issue 1, p264
Academic Journal
Absorption of 47Ca was measured with a method which assesses true absorption and shows good reproducibility in 256 subjects, including 47 normal, 16 with early renal failure (serum creatinines ≦2.5 mg/100 ml), 96 with advanced renal failure (serum creatinines > 2.5 mg/ 100 ml), 58 undergoing regular hemodialysis, and 39 renal transplant recipients. In normal subjects 47Ca absorption varied inversely with previous habitual dietary calcium intake, and absorption did riot differ from normal in patients with early renal failure. In patients with advanced renal failure and in those treated with hemodialysis. 47Ca absorption was below normal; deviation below normal was greater when dietary calcium intake was considered. In individual patients, calcium absorption often increased slightly with initiation of regular hemodialysis, bitt values generally remained sub-normal. Renal transplantation restored absorption to normal, but absorption was reduced in those with serum creatinine > 2.0 mg/ 100 ml and was inversely related to prednisone dosage. Thus true intestinal calcium absorption is clearly impaired with renal failure although the defect cannot be detected with mild renal failure. The diets of these patients contain low quantities of calcium, probably contributing to hypocalcemia in uremic patients. The impaired calcium absorption is discussed in relation to the kidney's role in producing 1.25-dihydroxycholecalciferol, the presumed active form of vitamin D.


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