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DrVirgo
Forum Junior  Topics: 731 Posts: 3487 |
What is the effect of Citrate on Calcium absorption? A. Increase B. Decrease C. No effect
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DrVirgo
| Forum Junior Topics: 731 Posts: 3487
I posted this question because I think there is a mistake in the Kap IM Nephrology notes... It says "Citrate usually binds with Calcium and PREVENTS Calcium Absorption. Low citrate leads to an increase in calcium absorption. Causes hypocitraturia include acidotic condition. As far as I know: Acid is necessary for Calcium absorption. If there is decreased acid, Calcium can be given with Citrate, (CitraCal) to increase absorption (as in people on PPI's or H2 Blockers). So CITRATE actually INCREASES the absorption of Calcium, NOT PREVENTS it, like in the notes... References: "calcium citrate does not need stomach acid to be broken down, and has unsurpassed absorption even when it is taken on an empty stomach." "Citracal is ideal for people taking acid-reducing agents such as antacids, H2 antagonists or prescription medications, such as Proton Pump Inhibitors (like Prilosec®*). The ease and efficiency with which our bodies process calcium citrate make it an ideal source of calcium. Citracal is also a logical choice for older individuals, because acid production decreases with age." www.citracal.com/citracal/c...itracal_aboutcitracal.aspx Please input any thoughts or ideas. Thanks. 
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Aashi
| Forum Moderator  Topics: 15 Posts: 805
Well Dr.Virgo Kaplan IM notes are right,and there r 1-2 qs on this in UW as well.. This is a notorious S.E of citrate ,when the pt is given a large amt of bld transfusions or when the pt is on citrate dialysis rather than on a heparin dialysis--->citrate toxicity--->hypocalcemic s/s( for reasons kaplan has given and which u had mentioned above) and METABOLIC ALKALOSIS--->citrate is different from citric acid--->citrate is citric acid MINUS 3 hydrogen ions-->so citrate is primarily a BASE rather than a acid--->and that explains why we get met.alkalosis as a S.E with citrate intoxication.. and giving calium citrate, which is calicium salts of citrate and citrate alone is diff, the former may be used in hypocalcemic situtaions, as a chelator etc and therefore the S.E-->of calcium citrate is hypercalcemia and acidosis( which is seen in pt on calicium citrate dialysis ) and while the latter(citrate alone) cozes hypocalcemia and meta.alkalosis. Any other inputs are welcome.. GL 
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DrVirgo
| Forum Junior Topics: 731 Posts: 3487
Great explanation Aashi! THANK YOU!
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