Calcium metabolism in health and disease
Abstract
This brief review focuses on calcium balance and homeostasis and their relationship to dietary calcium intake and calcium supplementation in healthy subjects and patients with chronic kidney disease and mineral bone disorders (CKD-MBD). Calcium balance refers to the state of the calcium body stores, primarily in bone, which are largely a function of dietary intake, intestinal absorption, renal excretion, and bone remodeling. Bone calcium balance can be positive, neutral, or negative, depending on a number of factors, including growth, aging, and acquired or inherited disorders. Calcium homeostasis refers to the hormonal regulation of serum ionized calcium by parathyroid hormone, 1,25-dihydroxyvitamin D, and serum ionized calcium itself, which together regulate calcium transport at the gut, kidney, and bone. Hypercalcemia and hypocalcemia indicate serious disruption of calcium homeostasis but do not reflect calcium balance on their own. Calcium balance studies have determined the dietary and supplemental calcium requirements needed to optimize bone mass in healthy subjects. However, similar studies are needed in CKD-MBD, which disrupts both calcium balance and homeostasis, because these data in healthy subjects may not be generalizable to this patient group. Importantly, increasing evidence suggests that calcium supplementation may enhance soft tissue calcification and cardiovascular disease in CKD-MBD. Further research is needed to elucidate the risks and mechanisms of soft tissue calcification with calcium supplementation in both healthy subjects and CKD-MBD patients.
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Only about 30% of dietary calcium is absorbed in healthy adults, and calcium-binding food components such as phytic acid, oxalic acid, and cellulose found in plant and whole-grain products lower calcium absorption further.
“Though individual foods differ, only ∼30% of dietary calcium is absorbed in healthy adults [267,268], and calcium-binding food components such as phytic acid, oxalic acid, and cellulose found in plant and whole-grain products lower calcium absorption further”
From Nutritional Considerations for the Vegan Athlete (2023) · cites this paper as [268]
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- Authors
- Peacock, M.
- Affiliations
- Indiana University School of Medicine (US)
- Corresponding author
- Peacock, Munro
- ORCID
- Peacock, Munro
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2010-01
- Volume
- 5
- Issue
- Supplement_1
- Pages
- S23-S30
- ISSN
- 1555-9041 (ISSN-L)
- OpenAlex
- W2153942663
- Cited by
- 886
- References
- 53
- Citations by year
- 2026: 50 · 2025: 62 · 2024: 75 · 2023: 65 · 2022: 82 · 2021: 80 · 2020: 81 · 2019: 63 · 2018: 52 · 2017: 45 · 2016: 48 · 2015: 46 · 2014: 36 · 2013: 34 · 2012: 33
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Keywords
- calcium metabolism, calcium balance, calcium homeostasis, calcium intake, calcium supplementation, chronic kidney disease-mineral and bone disorder, bone remodeling, parathyroid hormone, 1,25-dihydroxyvitamin D, hypercalcemia, hypocalcemia, calcinosis, cardiovascular disease, bone mass
- MeSH terms
- Animals, Bone and Bones, Calcium, Calcium, Dietary, Chronic Disease, Homeostasis, Humans, Hypercalcemia, Hypocalcemia, Intestinal Mucosa, Kidney, Kidney Diseases, Metabolic Diseases, Phosphates, Phosphorus, Vitamin D, Bone Remodeling, Hypophosphatemia, Nutrition Policy, Dietary Supplements, Hyperphosphatemia
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