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Published ahead of print on October 9, 2009
Clin J Am Soc Nephrol 4: 1980-1987, 2009
© 2009 American Society of Nephrology
doi: 10.2215/CJN.02620409
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Mineral Metabolism and Bone Disease

Demographic, Dietary, and Urinary Factors and 24-h Urinary Calcium Excretion

Eric N. Taylor*, and Gary C. Curhan*,{dagger}

* Renal Division and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; and {dagger} Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts

Correspondence: Dr. Eric N. Taylor,Channing Laboratory, Third Floor. Brigham and Women's Hospital. 181 Longwood Avenue. Boston, MA 02115. Phone: 617-525-2043; Fax: 617-525-2008; E-mail: entaylor{at}partners.org

Background and objectives: Higher urinary calcium is a risk factor for nephrolithiasis. This study delineated associations between demographic, dietary, and urinary factors and 24-h urinary calcium.

Design, setting, participants, & measurements: Cross-sectional studies were conducted of 2201 stone formers (SF) and 1167 nonstone formers (NSF) in the Health Professionals Follow-up Study (men) and Nurses' Health Studies I and II (older and younger women).

Results: Median urinary calcium was 182 mg/d in men, 182 mg/d in older women, and 192 mg/d in younger women. Compared with NSF, urinary calcium as a fraction of calcium intake was 33 to 38% higher in SF (P values ≤0.01). In regression analyses, participants were combined because associations with urinary calcium were similar in each cohort and in SF and NSF. After multivariate adjustment, participants in the highest quartile of calcium intake excreted 18 mg/d more urinary calcium than those in the lowest (P trend =0.01). Caffeine and family history of nephrolithiasis were positively associated, whereas urinary potassium, thiazides, gout, and age were inversely associated, with urinary calcium. After multivariate adjustment, participants in the highest quartiles of urinary magnesium, sodium, sulfate, citrate, phosphorus, and volume excreted 71 mg/d, 37 mg/d, 44 mg/d, 61 mg/d, 37 mg/d, and 24 mg/d more urinary calcium, respectively, than participants in the lowest (P values trend ≤0.01).

Conclusions: Intestinal calcium absorption and/or negative calcium balance is greater in SF than NSF. Higher calcium intakes at levels typically observed in free-living individuals are associated with only small increases in urinary calcium.




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