Acute decrease of urine calcium by amiloride in healthy volunteers under high sodium diet.

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State: Public
Version: Author's accepted manuscript
License: All rights reserved
Serval ID
serval:BIB_C900C42C9E5E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Acute decrease of urine calcium by amiloride in healthy volunteers under high sodium diet.
Journal
Nephrology, dialysis, transplantation
Author(s)
Harmacek D., Blanchard A., Wuerzner G., Maillard M., Jeunemaitre X., Azizi M., Bonny O.
ISSN
1460-2385 (Electronic)
ISSN-L
0931-0509
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Amiloride is a competitive blocker of the epithelial sodium channel (ENaC) in the renal collecting duct. It is a less potent diuretic than thiazides or loop diuretics, but is often used in association for its potassium-sparing profile. Whether amiloride has hypocalciuric effect similar to thiazides remains unclear. Animal studies and experiments on cell lines suggested that amiloride increases calcium reabsorption in the distal nephron, but human studies are scarce.
We performed a post hoc analysis of a study with 48 healthy males (age, 23.2 ± 3.9 years) who were assigned to a high sodium (Na)/low potassium (K) diet for 7 days before receiving 20 mg of amiloride p.o. Urinary excretions of electrolytes were measured at 3 and 6 hours afterward; we calculated the relative changes in urinary excretion rates after amiloride administration.
The high Na/low K diet led to an expected suppression of plasma renin and aldosterone. Amiloride showed a mild natriuretic effect associated with a decreased kaliuresis. Urinary calcium excretion dropped substantially (by 80%) 3 hours after amiloride administration and remained low at the 6th hour. At the same time, fractional excretion of lithium decreased by a third, reflecting an increased proximal tubular reabsorption.
During a high Na/low K diet, amiloride had a strong acute hypocalciuric effect, most probably mediated by increased proximal calcium reabsorption, even though distal effect cannot be excluded. Further studies should establish if chronic amiloride or combined amiloride/thiazide treatment may decrease calciuria more efficiently and be useful in preventing kidney stones.
Keywords
amiloride, healthy volunteers, kidney stone, thiazide, urine calcium
Pubmed
Funding(s)
SNF/Projects/310030-182312 SNF/Programs/183774 OTHER//Assistance Publique des Hôpitaux de Paris AOR0641
Create date
19/05/2021 14:01
Last modification date
16/07/2021 7:12
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