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Creighton University, Osteoporosis Research Center, Omaha, Nebraska
Address correspondence to: Karen Rafferty, R.D., Creighton University, 601 North 30th Street, Suite 5766, Omaha, NE 68131. E-mail: karenrd{at}creighton.edu
Background: Dietary potassium intake (K) lowers urinary calcium (Ca) excretion and, in short-term studies, may improve Ca balance.
Purpose: Our objective was to assess K effects on the Ca economy under steady-state conditions.
Design: 8-day, inpatient metabolic studies of nitrogen, phosphorus, and Ca balance, combined with dual isotopic Ca tracer kinetics studies. Study diet matched to prestudy nutrient intakes.
Subjects: 191 single women studied from 1–5 times at 
5-year intervals, for a total of 644 inpatient studies. Median age at time of study: 50.2 yrs; 301 studies were performed postmenopausally without hormone replacement; 343 were either premenopausal or postmenopausal but on estrogen replacement therapy.
Results: Dietary K was highly significantly associated with urinary Ca excretion, with a coefficient of –0.0109 mmol urine Ca/mmol diet K. However, dietary K was negatively correlated with dual-tracer Ca absorption (coefficient for Ca absorption fraction: –0.00094/mmol dietary K), and was not associated with urine Ca after adjustment for Ca absorption.
Conclusion: While a high K diet (i.e., one rich in fruits, vegetables, and dairy products) has multiple health benefits and clearly lowers urine Ca, it does not seem to exert any appreciable net influence on the Ca economy, largely because the reduced calciuria is offset by reduction of intestinal absorption. We note, however, that since the high K intakes in our studies come more from milk and meat than from fruits and vegetables, we cannot exclude a possible balance effect for different food sources of K.
Key words: urine calcium, calcium balance, potassium, calcium absorption, renal net acid excretion
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