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Effects of Potassium or Sodium Supplementation on Mineral Homeostasis: A Controlled Dietary Intervention Study.

Authors
  • Humalda, Jelmer K1
  • Yeung, Stanley M H1
  • Geleijnse, Johanna M2
  • Gijsbers, Lieke2
  • Riphagen, Ineke J3
  • Hoorn, Ewout J4
  • Rotmans, Joris I5
  • Vogt, Liffert6
  • Navis, Gerjan1
  • Bakker, Stephan J L1
  • de Borst, Martin H1
  • 1 Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands. , (Netherlands)
  • 2 Division of Human Nutrition and Health, Wageningen University, HB Wageningen, the Netherlands. , (Netherlands)
  • 3 Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands. , (Netherlands)
  • 4 Department of Internal Medicine, Division of Nephrology & Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, CA Rotterdam, The Netherlands. , (Netherlands)
  • 5 Department of Internal Medicine, Leiden University Medical Center, RC Leiden, the Netherlands. , (Netherlands)
  • 6 Department of Internal Medicine, Section of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, DD Amsterdam Zuidoost, the Netherlands. , (Netherlands)
Type
Published Article
Journal
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Publication Date
Sep 01, 2020
Volume
105
Issue
9
Identifiers
DOI: 10.1210/clinem/dgaa359
PMID: 32506135
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Although dietary potassium and sodium intake may influence calcium-phosphate metabolism and bone health, the effects on bone mineral parameters, including fibroblast growth factor 23 (FGF23), are unclear. Here, we investigated the effects of potassium or sodium supplementation on bone mineral parameters. We performed a post hoc analysis of a dietary controlled randomized, blinded, placebo-controlled crossover trial. Prehypertensive individuals not using antihypertensive medication (n = 36) received capsules containing potassium chloride (3 g/d), sodium chloride (3 g/d), or placebo. Linear mixed-effect models were used to estimate treatment effects. Potassium supplementation increased plasma phosphate (from 1.10 ± 0.19 to 1.15 ± 0.19 mmol/L, P = 0.004), in line with an increase in tubular maximum of phosphate reabsorption (from 0.93 ± 0.21 to 1.01 ± 0.20 mmol/L, P < 0.001). FGF23 decreased (114.3 [96.8-135.0] to 108.5 [93.5-125.9] RU/mL, P = 0.01), without change in parathyroid hormone and 25-hydroxy vitamin D3. Fractional calcium excretion decreased (from 1.25 ± 0.50 to 1.11 ± 0.46 %, P = 0.03) without change in plasma calcium. Sodium supplementation decreased both plasma phosphate (from 1.10 ± 0.19 to 1.06 ± 0.21 mmol/L, P = 0.03) and FGF23 (from 114.3 [96.8-135.0] to 108.7 [92.3-128.1] RU/mL, P = 0.02). Urinary and fractional calcium excretion increased (from 4.28 ± 1.91 to 5.45 ± 2.51 mmol/24 hours, P < 0.001, and from 1.25 ± 0.50 to 1.44 ± 0.54 %, P = 0.004, respectively). Potassium supplementation led to a decrease in FGF23, which was accompanied by increase in plasma phosphate and decreased calcium excretion. Sodium supplementation reduced FGF23, but this was accompanied by decrease in phosphate and increase in fractional calcium excretion. Our results indicate distinct effects of potassium and sodium intake on bone mineral parameters, including FGF23. NCT01575041. © Endocrine Society 2020.

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