Analysis of bone mineral density in urolithiasis patients

Abstract

Background : The association between hypercalciuria and bone mineral density (BMD) has been already recognized. The aim of the present study is to relate BMD to age and sex and to evaluate the calcium metabolism and hypercalciuria-defined dietary or non-dietary category in patients with urolithiasis.Methods : The BMI of the L2-L4 lumbar vertebrae was measured in 310 renal stone patients (191 men and 119 women). Percent age matched score (%AMS), which is the percent ratio of measured BMD to the mean BMD of age-matched control subjects, was utilized for the appraisal of BMD. Low BMD groups were defined by lower than 90% of %AMS. Results : Low BMD was observed in 27.7% of urinary stone patients, which was not a significant difference to that of control subjects (23.5%) who were measured in the health examination. In male patients with urolithiasis, the frequency of patients in whom BMD had been apt to decrease since youth was high, but there was not a proven significant difference among the three age groups (20-39 years old, 40-59 years old and 60 years old or older). In contrast, for female stone patients, the frequency of low BMD markedly increased in patients aged 40 years or older, when menopause occurs. Furthermore, in female stone patients with hypercalciuria, the frequency of reduced BMD reached more than 40%. When the cause was non-dietary hypercalciuria (classified mainly on the daily amount of urinary calcium excretion after ingestion of calculus test diet), the frequency of reduced BMD reached 65% ( P < 0.01).Conclusions : In case female stone patients with non-dietary hypercalciuria become menopausal, not only the risk of recurrent lithiasis increases, but the possibility of developing osteopenia in the future also increases. Appropriate treatments for prophylactic effects on urolithiasis or osteopenia should be considered, as judged from BMD, diet, sex, urinary calcium excretion and other factors synthetically.

Bone remodeling markers as lithogenic risk factors in patients with osteopenia–osteoporosis

“…The risk of symptomatic nephrolithiasis in patients with osteoporosis in a population-based 5-year follow-up study was 1.38 (CI 95 % 1.03-1.86) [11], so the presence of the lithogenic markers may help to predict the risk of nephrolithiasis in patients with osteopenia-osteoporosis. Hypercalciuria plays a key role in osteopenia-osteoporosis and is one of the most important lithogenic factors [12,13]. In comparison with the controls, the patients with osteopenia-osteoporosis had significantly higher fasting urine calcium levels and fasting calcium/creatinine ratios.…”

Urolithiasis in an Acute Lymphoblastic Leukemia Child During Induction Chemotherapy

“…Low BMD has been thought to be one of risk factor of urolithiasis [3][4][5][6]. Leakage of calcium from the bones is thought to increase calcium excretion and the risk of urinary stones.…”

Hip Strentgh Analysis By Dual Energy X-Ray Absorbtiometry in Nephrolithiasis Patients

“…In a study, decreased BMD value was detected in 10% patients between 20-50 ages when femoral and lumbar Z-score are considered [17]. Tsuji and et al [18] found low BMD values in 30% male (mean age 48.7 ± 13.9 years) and 26.2% female (mean age 52.9 ± 14.9 years) patients. Bones fail when stresses, ascribing forces, exceed the capacity of the structure.…”

“…They suggested that metabolic studies (such as bone remodelling markers (β-CrossLaps, osteocalcin and β-CrossLaps/osteocalcin), calciuria, fasting calcium/creatinine, 24-hour calcium/creatinine, citraturia and calcium/citrate) could be performed in patients with calcium renal stones and BMD loss for accurate therapy [15]. In a study done by Tsuji in 2005, they performed BMD in 310 patients and concluded that there were no differences in BMD values when both genders were considered however there was a significant difference when only female patients were considered [18]. The results of Moyano's study suggest independent to the presence or absence of hypercalciuric renal calcium lithiasis affect BMD more prominently at the femoral neck.…”