Nephrology Book

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Oral Calcium

Aka: Oral Calcium, Calcium Supplementation, Dietary Calcium, Calcium Carbonate, Calcium Citrate, Calcium Phosphate
  1. Indications: Osteoporosis Prevention
    1. Starting in childhood and adolescence preferable
    2. Begin at 35-40 years old if not already started
    3. Potentiates Estrogen Replacement Therapy
  2. Contraindications
    1. Hypercalciuria
    2. Nephrolithiasis
    3. Sarcoidosis
    4. Hyperparathyroidism
  3. Precautions
    1. Calcium Supplementation in Osteoporosis Prevention benefits may not outweigh cardiovascular and Nephrolithiasis risks
    2. Prevention of Hip Fracture with Calcium Supplementation Number Needed to Treat (NNT)
      1. Adults living in the community: 1000
      2. Older persons: 302
      3. Nursing Home resident: 111
    3. References
      1. Avenell (2014) Cochrane Database Syst Rev (4):CD000227 [PubMed]
      2. Lesser (2015) Am Fam Physician 91(9):634-8 [PubMed]
  4. Adverse Effects
    1. Nephrolithiasis
    2. Cardiovascular disease risk (mixed evidence)
      1. CAD Risk not increased at standard calcium dose (but may be increased at high dose >1500-2000/day)
      2. Bolland (2008) BMJ 336(7638):262-6 [PubMed]
      3. Chung (2016) Ann Intern Med 165(12): 856-66 +PMID:27776363 [PubMed]
  5. Dosing: Calcium daily requirements
    1. Calcium is best absorbed in doses of 500 mg or less
    2. Do not exceed calcium 2500 mg/day in men or 2000 mg/day in women (Hypercalcemia risk)
    3. Daily dose of 1000 mg Calcium Indications
      1. Men and women ages 25 to 50 years
      2. Men 50 to 65 years
      3. Women on Estrogen Replacement ages 50-65 years
    4. Dose 1200 to 1500 mg Calcium Indications (some guidelines recommend 1000 mg daily for these groups)
      1. Ages 11 to 24 years
      2. Post-menopausal women not on Estrogen Replacement
      3. Age over 65 years
      4. Pregnancy
      5. Lactation
  6. Preparations: Dietary Calcium Sources (300 mg elemental calcium in each)
    1. Yogurt or frozen yogurt 8 ounces
    2. Calcium-Fortified Orange Juice 8 ounces
    3. Milk 8 ounces
    4. Firm Cheese 1 to 1.5 ounces
    5. Canned Sardines 3 ounces
    6. Cooked greens, collards, or mustard 1-2 cups or 8 oz
  7. Preparations: Calcium Carbonate
    1. Advantages
      1. Most elemental calcium (40%)
      2. Tablet 650 mg contains 250 mg elemental calcium
      3. Least expensive calcium preparation
    2. Administration
      1. Take with meals or citrus juice
      2. Absorption reduced with Fasting or achlorhydria
    3. Preparations
      1. Tums 500 mg orall daily to three times daily
    4. Adverse effects
      1. Constipation
  8. Preparations: Calcium Citrate
    1. Advantages
      1. No Constipation
      2. Better absorption than Calcium Carbonate by >20% especially in low gastric acid state
        1. Sakhaee (1999) Am J Ther 6(6):313-21 [PubMed]
    2. Indications:
      1. Constipation or gas on Calcium Carbonate
      2. Calcium based Kidney stones
      3. Gastric acid suppression medications (Proton Pump Inhibitors, H2 Blockers)
      4. Elderly patients
    3. Administration
      1. Take on an empty Stomach
  9. Preparations: Calcium Phosphate
    1. Advantages
      1. No Constipation
      2. Absorption: 39%
    2. Disadvantages
      1. Cost
Medication Costs
calcium carbonate (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
CALCIUM CARBONATE 1.25 GM TAB Generic OTC $0.06 each
CALCIUM CARBONATE 648 MG TAB Generic OTC $0.01 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Calcium Carbonate (C0006681)

Definition (MSHCZE) CaCO3, většinou jako bílý precipitát; nerost (viz kalcit), nachází se v popelu rostlin, kostech, skořápkách. Používá se jako pigment, plnivo, k dentálním a farmaceutickým účelům, jako antacidum. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI_NCI-GLOSS) A form of the mineral calcium that is used to prevent or treat osteoporosis (a decrease in bone mass and density) and to treat heartburn and upset stomach. It is also being studied in the prevention of bone problems in people with cancer. It is a type of dietary supplement.
Definition (NCI) The carbonic salt of calcium (CaCO3). Calcium carbonate is used therapeutically as a phosphate buffer in hemodialysis, as an antacid in gastric hyperacidity for temporary relief of indigestion and heartburn, and as a calcium supplement for preventing and treating osteoporosis. (NCI04)
Definition (MSH) Carbonic acid calcium salt (CaCO3). An odorless, tasteless powder or crystal that occurs in nature. It is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement.
Definition (CSP) carbonic acid calcium salt (CaCO3) used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement.
Definition (PDQ) The carbonic salt of calcium (CaCO3). Calcium carbonate is used therapeutically as a phosphate buffer in hemodialysis, as an antacid in gastric hyperacidity for temporary relief of indigestion and heartburn, and as a calcium supplement for preventing and treating osteoporosis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39679&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39679&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C332" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Inorganic Chemical (T197)
MSH D002119
SnomedCT 387307005, 55217007
LNC LP16845-7
English Calcium Carbonate, Carbonate, Calcium, Carbonic acid calcium salt (1:1), CaCO3, mineral supplements calcium carbonate, calcium carbonate (medication), calcium (as carbonate), calcium carbonate as antacid, calcium carbonate as antacid (medication), calcium carbonate, CALCIUM CARBONATE, Calcium Carbonate [Chemical/Ingredient], calcium carbonated, calcium carbonates, Calcium carbonate, Calcium carbonate (product), Calcium carbonate (substance), CALCIUM (AS CALCIUM CARBONATE), CALCIUM (AS CARBONATE), Antacid (Calcium Carbonate)
French CaCO3, Carbonate de calcium
Swedish Kalciumkarbonat
Czech uhličitan vápenatý
Finnish Kalsiumkarbonaatti
Russian KAL'TSIIA KARBONAT, КАЛЬЦИЯ КАРБОНАТ
Japanese 霰石, 炭酸石灰, 炭酸カルシウム, あられ石
Polish Węglan wapniowy
Norwegian Kalsiumkarbonat
Spanish carbonato de calcio (producto), carbonato de calcio (sustancia), carbonato de calcio nativo purificado, carbonato de calcio, Carbonato de Calcio
German Calciumcarbonat, Kalziumkarbonat
Italian Carbonato di calcio
Portuguese Carbonato de Cálcio
Sources
Derived from the NIH UMLS (Unified Medical Language System)


calcium phosphate (C0006711)

Definition (CSP) calcium salts containing the phosphate radical (PO4), frequently used as calcium supplements.
Concepts Pharmacologic Substance (T121) , Inorganic Chemical (T197)
MSH C020243
SnomedCT 259546007, 44044007, 419939009
LNC LP16847-3
English calcium phosphate, calcium (as phosphate), calcium phosphate [Chemical/Ingredient], calciums phosphates, calcium phosphate product, phosphate calcium, Calcium Phosphate, CALCIUM PHOSPHATE, Calcium phosphate, Calcium phosphate product, Calcium phosphate (substance), Calcium phosphate [dup] (substance), Calcium phosphate agent, Calcium phosphate (product)
Spanish fosfato de calcio, fosfato de calcio (producto), fosfato cálcico (sustancia), fosfato cálcico
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Calcium, Dietary (C0006726)

Definition (MEDLINEPLUS)

You have more calcium in your body than any other mineral. Calcium has many important jobs. The body stores more than 99 percent of its calcium in the bones and teeth to help make and keep them strong. The rest is throughout the body in blood, muscle and the fluid between cells. Your body needs calcium to help muscles and blood vessels contract and expand, to secrete hormones and enzymes and to send messages through the nervous system.

It is important to get plenty of calcium in the foods you eat. Foods rich in calcium include dairy products such as milk, cheese and yogurt, and leafy, green vegetables. The exact amount of calcium you need depends on your age and other factors. Growing children and teenagers need more calcium than young adults. Older women need plenty of calcium to prevent osteoporosis. People who do not eat enough high-calcium foods should take a calcium supplement.

NIH: National Institutes of Health Office of Dietary Supplements

Definition (NCI_CRCH) Forms of the element calcium found in foods.
Definition (MSH) Calcium compounds used as food supplements or in food to supply the body with calcium. Dietary calcium is needed during growth for bone development and for maintenance of skeletal integrity later in life to prevent osteoporosis.
Definition (CSP) calcium compounds used as food supplements or in food to supply the body with calcium; dietary calcium is needed during growth for bone development and for maintenance of skeletal integrity later in life to prevent osteoporosis.
Concepts Inorganic Chemical (T197)
MSH D002136
English Dietary Calcium, Calcium, Dietary, Calcium, Dietary [Chemical/Ingredient], dietary calcium, calcium dietary, Calcium
Swedish Kalcium i kosten
Czech vápník dietní
Finnish Ravinnon kalsium
Russian KAL'TSII PISHCHEVOI, PISHCHEVOI KAL'TSII, КАЛЬЦИЙ ПИЩЕВОЙ, ПИЩЕВОЙ КАЛЬЦИЙ
Croatian KALCIJ U HRANI
Polish Wapń w pokarmach
Japanese カルシウム-食品, 食品中のカルシウム, 食品カルシウム, 食物カルシウム, 食用カルシウム, 食品中のカルシウム成分
French Calcium alimentaire
German Nahrungscalcium, Nahrungskalzium
Italian Calcio alimentare
Portuguese Cálcio na Dieta
Spanish Calcio en la Dieta
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Calcium Citrate (C0108101)

Definition (NCI) The citrate salt of calcium. An element necessary for normal nerve, muscle, and cardiac function, calcium as the citrate salt helps to maintain calcium balance and prevent bone loss when taken orally. This agent may also be chemopreventive for colon and other cancers. (NCI04)
Definition (MSH) A colorless crystalline or white powdery organic, tricarboxylic acid occurring in plants, especially citrus fruits, and used as a flavoring agent, as an antioxidant in foods, and as a sequestrating agent. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)
Definition (PDQ) The citrate salt of calcium. An element necessary for normal nerve, muscle, and cardiac function, calcium as the citrate salt helps to maintain calcium balance and prevent bone loss when taken orally. This agent may also be chemopreventive for colon and other cancers. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41817&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41817&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1355" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D019355
SnomedCT 52209008
English Calcium Citrate, Citrate, Calcium, Calcium Citrates, Citrates, Calcium, TRICALCIUM CITRATE, 2-Hydroxy-1,2,3-propanetricarboxylic Acid, Calcium Salt (2:3), Tricalcium Citrate, calcium citrate (medication), mineral supplements calcium citrate, Calcium Citrate [Chemical/Ingredient], CALCIUM CITRATE, calcium citrates, citrate calcium, calcium citrated, calcium citrate, calcium (as citrate), Calcium citrate, Calcium citrate (substance), CALCIT, CALCIUM (AS CITRATE)
French Citrate de calcium
Swedish Kalciumcitrat
Czech kalciumcitrát, citran vápenatý
Finnish Kalsiumsitraatti
Russian KAL'TSIIA TSITRAT, КАЛЬЦИЯ ЦИТРАТ
Polish Cytrynian wapniowy
Norwegian Kalsiumcitrat
Spanish citrato de calcio (sustancia), citrato de calcio, Citrato de Calcio
German Calciumcitrat, Kalziumcitrat
Italian Calcio citrato
Dutch Calciumcitraat
Portuguese Citrato de Cálcio
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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