Pumarino H
Departamento de Medicina, Hospital Clínico José Joaquín Aguirre, Facultad de Medicina, Universidad de Chile, Santiago.
Rev Med Chil. 1990 Apr;118(4):437-40.
A 61 year old man with a calcic urinary stone at age 46 was submitted to a prolonged low calcium diet (about 400 mg/day). Normal serum calcium and elevated urinary Ca (725 mg/day were demonstrated). After a diet with a normal Ca content (900 mg/day) urinary excretion did not change. PTH, serum Ca and P were normal. Biphoton bone densitometry revealed severe osteopenia, with a spine density of 51% of normal. The addition of hydrocortisone (50 mg/day) reduced urinary Ca output over 25%; the addition of phosphate, 1125 mg/day, brought Ca output to normal levels. Thus, prolonged dietary restriction of Ca in the presence of high urinary Ca loss may produce severe osteopenia and osteoporosis.
一名61岁男性，46岁时患有钙质性尿路结石，接受了长期低钙饮食（约400毫克/天）。结果显示血清钙正常，但尿钙升高（725毫克/天）。在摄入正常钙含量（900毫克/天）的饮食后，尿钙排泄量没有变化。甲状旁腺激素、血清钙和磷均正常。双能X线骨密度测定显示严重骨质减少，脊柱密度为正常的51%。添加氢化可的松（50毫克/天）可使尿钙排出量减少超过25%；添加磷酸盐，1125毫克/天，可使钙排出量恢复正常水平。因此，在尿钙大量流失的情况下，长期限制饮食中的钙可能会导致严重的骨质减少和骨质疏松。
