Analysis of Bone Density in Patients with Urolithiasis; Role of Hypercalciuria in Bone Loss: Do These Patients Need a Low-Calcium Diet?
DOI:
https://doi.org/10.22100/jkh.v3i3-4.219Keywords:
Kidney stone, Hypercalciuria, Low-calcium diets.Abstract
Introduction: Kidney stone is a common urologic complaint. In this study, bone density in stone formers was compared with that of a control group; bone density of stone formers was also analyzed based on age, sex and stone configuration.
Methods: In a group of 85 patients with upper urinary calcium stones and 85 healthy people, variables such as age, height, weight, BMI, T-score and Z-score results of bone densitometry of lumbar vertebrae (L2-L4) and femoral neck were recorded. The serum levels of uric acid, calcium, potassium, sodium, phosphor, alkaline phosphates and parathyroid hormone were also analyzed and recorded. Furthermore, all patients' 24-hour urine was studied for levels of cr, oxalate, citrate, uric acid calcium, urea and the total volume.
Results: Lumbar and femoral bone mineral density (BMD) was significantly lower in patients suffering from renal stone. This difference was also significant when the study and control groups were classified into hypercalciuric and normocalciuric ones. Based on the densimetric results of lumbar vertebrae and femoral neck, BMD reduction among menopause women was significantly greater.Conclusion: Noting the lack of relationship between hypercalciuria and bone loss, and noting that a low-calcium diet not only has no proved role in renal stone prevention, but also it leads to calcium imbalance and finally bone loss, low-calcium diets are not suggested for renal stone formers.
References
Anderson RA. A complementary approach to urolithiasis prevention. World J Urol 2002;20(5):294-301.
Audi L, García-Ramírez M, Carracosa A. Genetic determinants of bone mass. Horm Res 1999;51(3):105-123.
Pak CY, Britton F, Peterson R, Ward D, Northcutt C, Breslau NA. Ambulatory evaluation of nephrolithiasis. Classification, clinical presentation and diagnostic criteria. Am J Med 1980;69(1):19-30.
Caudarella R, Vescini F, Buffa A, Manna L, Stefoni S. Osteoprosis and urolithiasis. Urol Int 2004;72(1):17-19.
Pietschmann F, Breslau NA, Pak CYC. Reduced vertebral bone density in hypercalciuric nephrolithiasis. JBMR 1992;7(12):1383- 1388.
Zanchetta JR, Rodriguez G, Negri AL, del Valle E, Spivacow FR. Bone mineral density in patients with hypercalciuric nephrolithiasis. Nephron 1996;73(4):557-560.
Alhava EM, Juuti M, Karjalainen P. Bone mineral density in patients with urolithiasis: A preliminary report. Scand J Urol Nephrol 1976;10(2):154-156.
Trinchieri A, Nespoli R, Ostini F, Rovera F, Zanetti G, Pisani E. A study of dietary calcium and other nutrients in idiopathic renal calcium stone formers with low bone mineral content. J Urol 1998;159(3):654-657.
Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-3232.
Siener R, Ebert D, Nicolay C, Hesse A. Dietary risk factors for hyperoxaluria in calcium oxalate stone formers. Kidney Int 2003; 63:1037-1043.
Hisazumi H, Katsumi T. A study of the mineral contents of the bone by x-rays in patients with urolithiasis. Nippon Hinyokika Gakkai Zasshi 1970;61(3):266-270.
Grases F, Costa-Bauza A, Prieto RM. Renal lithiasis and nutrition. Nutr J 2006;5:23.
Ljunghall S, Johansson AG, Burman P, Kampe O, Lindh E, Karlsson FA. Low plasma level of insulin-like growth factor 1 (IGF-1) in male patients with idiopathic osteoporosis. J Intern Med 1992;232(1):59-64.
Slemenda CW, Hui SL, Williams CJ, Christian JC, Meaney FJ, Johnston CC. Bone mass and anthropometric measurements in adult females. Bone Miner 1990;11(1):101-109.
Jaeger P, Lippuner K, Casez JP, Hess B, Ackermann D, Hugh C. Low bone mass in idiopathic renal stone formers: magnitude and significance. J Bone Miner Res 1994;9(10):1525-32.
Favus MJ, Goldring SR, Christakos S, editors. Primer on the metabolic bone diseases and disorders of mineral metabolism. An official publication of the American Society for Bone and Mineral Research. Philadelphia:Lipincott-Raven;1996.
Trinchieri A, Nespoli R, Ostini F, Rovera F, Zanetti G, Pisani E. A study of dietary calcium and other nutrients in idiopathic renal calcium stone formers with low bone mineral content. J Urol 1998; 159(3):654-657.
Heilberg IP, Martini LA, Szejnfeld VL, Carvalho AB, Draibe SA, Ajzen H, et al. Bone disease in calcium stone forming patients. Clin Nephrol 1994;42(3):175-182.
Curhan GC, Willett WC, Rimm EB, Stampfer MJ. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 1993;328(12):833-838.
Matkovic V, Heaney RP. Calcium balance during human growth: evidence for threshold behavior. Am J Clin Nutr 1992;55(5):992-996.
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