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Melissa O. Premaor, MD; Roberta Vanacour, MSc; Tania W. Furlanetto, PhD

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The article by Dickinson and Havas¹ is extremely relevant for clinical practice. However, the important association between urinary calcium and sodium excretion was not emphasized. A study realized by Carbone et al² found that approximately 1.2 mmol/L of calcium (to convert to milligrams per deciliter, multiply by 4) were excreted per 100 mmol/L of sodium (the conversion to milliequivalents per liter is a 1-to-1 conversion), and this relationship was independent of race. As a result, in subjects with a high sodium intake, a urinary calcium loss could generate a compensatory increase in serum parathyroid hormone levels. High serum parathyroid hormone levels have been associated with high body mass index,³ high blood pressure,⁴ and metabolic syndrome.⁵ The cardiovascular risk attributed to a high sodium intake may have other indirect mechanisms in addition to those traditionally described.

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Correspondence: Dr Premaor, Department . . . [Full Text of this Article]

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Cardiovascular Disease, Sodium Intake, and Urinary Calcium Loss—Reply
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