Urine calcium

Calcium, urine 0-300 mg/24 h, or 0.0-7.5 mmol/24 h. Ionized calcium (serum calcium not bound to protein) ranges in adults from 4.65 to 5.28 mg/ dL. The level of ionized calcium in the blood is not affected by the amount of protein in the blood. 

Two nucleation processes important to many people (including some surface scientists ) occur in the formation of gallstones in human bile and kidney stones in urine. Cholesterol crystallization in bile causes the formation of gallstones. Cryotransmission microscopy (Chapter VIII) studies of human bile reveal vesicles, micelles, and potential early crystallites indicating that the cholesterol crystallization in bile is not cooperative and the true nucleation time may be much shorter than that found by standard clinical analysis by light microscopy [75]. Kidney stones often form from crystals of calcium oxalates in urine. Inhibitors can prevent nucleation and influence the solid phase and intercrystallite interactions [76, 77]. Citrate, for example, is an important physiological inhibitor to the formation of calcium renal stones. Electrokinetic studies (see Section V-6) have shown the effect of various inhibitors on the surface potential and colloidal stability of micrometer-sized dispersions of calcium oxalate crystals formed in synthetic urine [78, 79]. 

The amount of calcium in a sample of urine was determined by a method for which magnesium is an interferent. The selectivity coefficient, Rca.Mg> for the method is 0.843. When a sample with a Mg/Ca ratio of 0.50 was carried through the procedure, an error of-3.7% was obtained. The error was +5.5% when a sample with a Mg/Ca ratio of 2.0 was used. 

Most potentiometric electrodes are selective for only the free, uncomplexed analyte and do not respond to complexed forms of the analyte. Solution conditions, therefore, must be carefully controlled if the purpose of the analysis is to determine the analyte s total concentration. On the other hand, this selectivity provides a significant advantage over other quantitative methods of analysis when it is necessary to determine the concentration of free ions. For example, calcium is present in urine both as free Ca + ions and as protein-bound Ca + ions. If a urine sample is analyzed by atomic absorption spectroscopy, the signal is proportional to the total concentration of Ca +, since both free and bound calcium are atomized. Analysis with a Ca + ISE, however, gives a signal that is a function of only free Ca + ions since the protein-bound ions cannot interact with the electrode s membrane. 

Factors controlling calcium homeostasis are calcitonin, parathyroid hormone(PTH), and a vitamin D metabolite. Calcitonin, a polypeptide of 32 amino acid residues, mol wt - SGOO, is synthesized by the thyroid gland. Release is stimulated by small increases in blood Ca " concentration. The sites of action of calcitonin are the bones and kidneys. Calcitonin increases bone calcification, thereby inhibiting resorption. In the kidney, it inhibits Ca " reabsorption and increases Ca " excretion in urine. Calcitonin operates via a cyclic adenosine monophosphate (cAMP) mechanism. 

The potassium or calcium salt form of oxaUc acid is distributed widely ia the plant kingdom. Its name is derived from the Greek o>ys, meaning sharp or acidic, referring to the acidity common ia the foflage of certain plants (notably Oxalis and Mmex) from which it was first isolated. Other plants ia which oxahc acid is found are spinach, rhubarb, etc. Oxahc acid is a product of metabohsm of fungi or bacteria and also occurs ia human and animal urine the calcium salt is a principal constituent of kidney stones. 

Health and Safety Factors. Terephthahc acid has a low order of toxicity. Inhalation by rats for 6 h/d, 5 d/wk for 4 wk produced no fatahties at a dust exposure level of 25 mg/m. The mean acute oral toxicity for rats is over 18 g/kg (86), and for mice over 6 g/kg (87). When terephthahc acid was fed as 3% of the diet to rats, urinary calcuh formed in 90 d, some of which led to cancer. High doses of terephthahc acid lead to formation of calcium terephthalate at levels exceeding its solubihty in urine. This insoluble material leads to the calcuh and provides a threshold below which cancer is not observed (88). Normal precautions used in handling industrial chemicals should be observed with terephthahc acid. If ventilation is inadequate, a toxic-dust respirator should be used to avoid prolonged exposure. 

Three hormones regulate turnover of calcium in the body (22). 1,25-Dihydroxycholecalciferol is a steroid derivative made by the combined action of the skin, Hver, and kidneys, or furnished by dietary factors with vitamin D activity. The apparent action of this compound is to promote the transcription of genes for proteins that faciUtate transport of calcium and phosphate ions through the plasma membrane. Parathormone (PTH) is a polypeptide hormone secreted by the parathyroid gland, in response to a fall in extracellular Ca(Il). It acts on bones and kidneys in concert with 1,25-dihydroxycholecalciferol to stimulate resorption of bone and reabsorption of calcium from the glomerular filtrate. Calcitonin, the third hormone, is a polypeptide secreted by the thyroid gland in response to a rise in blood Ca(Il) concentration. Its production leads to an increase in bone deposition, increased loss of calcium and phosphate in the urine, and inhibition of the synthesis of 1,25-dihydroxycholecalciferol. 

Ion-selective electrodes are available for the electro analysis of most small anions, eg, haUdes, sulfide, carbonate, nitrate, etc, and cations, eg, lithium, sodium, potassium, hydrogen, magnesium, calcium, etc, but having varying degrees of selectivity. The most successful uses of these electrodes involve process monitoring, eg, for pH, where precision beyond the unstable reference electrode s abiUty to deUver is not generally required, and for clinical apphcations, eg, sodium, potassium, chloride, and carbonate in blood, urine, and semm. 

Hartel, R.W. and Randolph, A.D., 1986. Mechanisms and kinetic modelling of calcium oxalate crystals in urine-like liquor Part II kinetic modelling. American Institution of Chemical Engineers Journal, 32, 1186-1195. 

The presence of sparingly soluble components in human urine, such as calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid and l-cystine. Kidney stones are composed mainly of these compounds. 

Biochemical characteristics (plasma levels of alanine and aspartate transminases, alkaline phosphatase, triglycerides, cholesterol, urea, uric acid, allantoin, glucose, protein, albumin, sodium, potassium, calcium, magnesium, phosphorus urine levels of protein and glucose). 

PTH is the most important regulator of bone remodelling and calcium homeostasis. PTH is an 84-amino acid polypeptide and is secreted by the parathyroid glands in response to reductions in blood levels of ionised calcium. The primary physiological effect of PTH is to increase serum calcium. To this aim, PTH acts on the kidney to decrease urine calcium, increase mine phosphate, and increase the conversion of 25-OH-vitamin D to l,25-(OH)2-vitamin D. PTH acts on bone acutely to increase bone resorption and thus release skeletal calcium into the circulation. However, due to the coupling of bone resorption and bone formation, the longer-term effect of increased PTH secretion is to increase both bone resorption and bone formation. 

In the rare hereditary disease essential pentosuria, considerable quantities of L-xylulose appear in the urine because of absence of the enzyme necessary to reduce L-xylulose to xyhtol. Parenteral administration of xylitol may lead to oxalosis, involving calcium oxalate deposition in brain and kidneys (Figure 20-4). Various drugs markedly increase the rate at which glucose enters the... 

We have found that the use of serum standards for standardizing the instrument in the laboratory is useful. However, the serum standards cannot be used for urines. In urines, one runs into other problems and needs to use aqueous standards. Therefore, at present, while atomic absorption is the instrument of choice, there is much to be desired for the determination of calcium and magnesium in the routine laboratory of clinical chemistry. 

Calcium exists in the human body as Ca(II) protein-bound and free Ca (II) ions (Dilana et al. 1994). For total extracellular Ca in plasma, serum and urine a definitive isotope dilution-mass spectrometry (ID-MS) method exist. Free Ca(II) in plasma/serum can be determined with PISE, but no definitive and reference methods exist. For Ca in faeces, tissue and blood flame atomic absorption (FAAS) is used widely. 

A negative correlation was found between PbB and systolic pressure in Belgian men in the Cadmibel study (a cross-sectional population study of the health effects of environmental exposure to cadmium) (Staessen et al. 1991). In this study, blood pressure and urinary cation (positive ions found in the urine, such as sodium, potassium, and calcium) concentration data were obtained from 963 men and 1,019 women multiple stepwise regression analyses were conducted adjusting for age, body mass index, pulse... 

Urinary lead levels have also been used to measure current exposure (Robinson 1974) but they are of questionable value as biomarkers of exposure because of the relatively low and fluctuating lead levels that are excreted in the urine (ACGIH 1986 Ibels and Pollock 1986 Jensen 1984). In contrast, the determination of urinary lead following a single injection of the chelating agent, calcium disodium EDTA, which mobilizes extracellular lead and produces increased urinary excretion of lead, is presumed to be indicative of an elevated body burden of lead (Cory-Slechta et al. 1987 Ibels and Pollock 1986 Janin et al. 1985). Children whose PbB levels are 45 pg/dL should not receive a provocative chelation... 

Parathyroid hormone stimulates bone resorption by increasing the number and activity of osteoclasts. This demineralization process in the bone releases calcium and phosphate into the blood. Although the action of PTH on the bone appears to increase blood phosphate, its action on the kidney, which increases phosphate excretion in the urine, more than compensates for this increase and the net effect is a decrease in serum phosphate. 

Clinical chemistry, particularly the determination of the biologically relevant electrolytes in physiological fluids, remains the key area of ISEs application [15], as billions of routine measurements with ISEs are performed each year all over the world [16], The concentration ranges for the most important physiological ions detectable in blood fluids with polymeric ISEs are shown in Table 4.1. Sensors for pH and for ionized calcium, potassium and sodium are approved by the International Federation of Clinical Chemistry (IFCC) and implemented into commercially available clinical analyzers [17], Moreover, magnesium, lithium, and chloride ions are also widely detected by corresponding ISEs in blood liquids, urine, hemodialysis solutions, and elsewhere. Sensors for the determination of physiologically relevant polyions (heparin and protamine), dissolved carbon dioxide, phosphates, and other blood analytes, intensively studied over the years, are on their way to replace less reliable and/or awkward analytical procedures for blood analysis (see below). 

In a study with 40 healthy men and women, average age 63.7 years, who were randomized to either an alkali diet (meat plus fruits and vegetables) or an acid diet (meat plus cereal grains) (Jajoo and others 2006), altering the renal net acid excretion over a period of 60 days affected several biochemical markers of bone turnover and calcium excretion. The acidity of the diet had a significant effect on increasing NTX, a urinary marker of bone breakdown, and increasing the amount of calcium excreted in the urine. 

Calcium oxalate (723) occurs as the monohydrate (whewellite, the thermodynamically stable form under ambient conditions (724)), the dihydrate (weddellite) in plant calcium stores and in sap, or the trihydrate (725). Calcium oxalate also plays a structural role in plants. Oxalate, for example from excessive amounts of rhubarb or spinach, inhibits absorption of Ca2+ from the GIT precipitation of calcium oxalate is the reason for the toxicity of oxalates. Calcium oxalate may also occur in man, where it can appear as minute star-shaped crystals in the urine. It is the main constituent of the majority of urinary calculi in man (726,727). The relationships between dietary calcium... 

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