How Protective Mechanisms Interact to Prevent Overnight Calcium Phosphate Precipitation - An Observational Study to Determine Factors Against Calcium Phosphate Lithogenesis in a Healthy Cohort

Nephron
Mohammad A ShafieeMitchell L Halperin

Abstract

As restful, non-interrupted sleep is essential for normal mental and physical functioning, the urine flow rate (UFR) overnight remains low. Due to this reduced UFR, the kidneys produce a lower urine volume, which may lead to supersaturation of lithogens in the renal collecting system. The protective mechanisms that prevent the rise in the concentration of the lithogenic substances in urine, such as calcium phosphate, are explored. Urine samples were collected from 26 subjects every 2-3 h during daylight with one nocturnal collection; the UFR was calculated in the median time for each collection period. Urinary constituents for calcium phosphate precipitation including electrolytes, calcium, phosphate, citrate, and pH were measured. Comparisons within individuals were done by paired t test. The calcium excretion rate fell significantly overnight (from 2.4 ± 0.2 µmol/min during the daytime to 1.5 ± 0.3 µmol/min, p < 0.05), in parallel with sodium excretion (54 ± 16 µmol/min from its daytime 127 ± 12 µmol/min, p < 0.05), preventing nocturnal calcium concentration from increasing (3.0 ± 0.3 mmol/l daytime to 2.5 ± 0.5 mmol/l overnight), while citrate concentration did not change significantly. The total urine phosphate concentratio...Continue Reading

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