Bone mineral density in children with myelomeningocele: effect of hydrochlorothiazide

Quan, Albert; Adams, Richard N.; Ekmark, Elaine; Baum, Michel

doi:10.1007/s00467-003-1204-3

Cited by 19 publications

(15 citation statements)

References 22 publications

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“…Serum calcium was also checked simultaneously with urine calcium in the first, second and third week, although it was higher than the baseline level in the third week of immobilization but the P value didn't reach a statistically significant level (p = 0.057). Regarding the serum calcium level, we didn't reach the same conclusion as previous studies which were mostly case reports (12,13,16,18,22,23). In some of these reports, the period of immobilization was more than that of our study.…”

Section: Discussioncontrasting

confidence: 54%

“…Hypercalciuria is a known consequence of long and intermediate term immobilization which leads to decreased bone mineral density. This entity has been studied in patients with stroke and long term immobilization and also in children with intermediate term immobilization with Legg-Calvé-Perthes disease and developmental dysplasia of the hip joint (12)(13)(14). In this study, even after one week of immobilization in children with Legg-CalvePerthes disease urine calcium increased 2.3 times as compared to the baseline value but this did not happen in children with developmental dysplasia of the hip who had never been ambulated before immobilization.…”

Section: Discussionmentioning

confidence: 99%

“…Although it is transient and improves with subsequent mobilization, it is needed to be considered specifically by the team caring for this group of patients. immobilized (12,13). Also the effect of immobilization on hypercalciuria and hypercalcemia at intermediate term has been studied (14).…”

mentioning

confidence: 99%

“…immobilized (12,13). Also the effect of immobilization on hypercalciuria and hypercalcemia at intermediate term has been studied (14).…”

mentioning

confidence: 99%

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Effect of immobilization on urine calcium excretion in orthopedic patients with pelvic fracture treated by skin traction

Derakhshan

Namazi

et al. 2015

Arch Ital Urol Androl

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Objectives: To determine the effects on urine calcium excretion of immobilization by skin traction in patients with pelvic fracture. Methods: In a prospective study, a consecutive series of patients with pelvic fracture treated by skin traction were enrolled. Serum (calcium, phosphorous, alkaline phosphatase, sodium, potassium, uric acid, BUN, creatinine) and fasting urine calcium, creatinine, sodium, potassium and uric acid were checked within 48 hours of hospitalization and at 7, 14 and 21 days of immobilization and then after 3 months of mobilization. Trends in changes of variables were recorded. Results: Fifty five patients were enrolled in this study; they were 45 (81.8%) males and 10 (18.2%) females with a mean age 19.4 ± 12.7 years. We found that serum levels of calcium (p = 0.004), phosphorous (p = 0.047) and alkaline phosphatase (p = 0.001) increased significantly during the 3 weeks of immobilization. In the same way, urine calcium/urine creatinine ratio increased significantly in the study period (p = 0.004). No symptomatic renal stone formation was observed during the study period. Conclusions: Immobilization even in short term causes hypercalciuria in orthopedic patients. Although it is transient and improves with subsequent mobilization, it is needed to be considered specifically by the team caring for this group of patients. immobilized (12,13). Also the effect of immobilization on hypercalciuria and hypercalcemia at intermediate term has been studied (14). There are only few reports (mostly case reports) regarding the hypercalciuria in patients who are immobilized temporarily due to orthopedic fractures (15)(16)(17)(18)(19)(20). In this study, we have investigated the effect of short term immobilization on urinary calcium excretion and also on serum calcium and parathormone in patients who are immobilized with skin or skeletal traction for a pelvic fracture in orthopedic wards. PATIENTS AND METHOD Study populationThis was a prospective cross-sectional study being performed during a 1-year period from 2012 to 2013 in Chamran and Nemazi hospitals, both tertiary orthopedics healthcare centers affiliated with Shiraz University of Medical Sciences. The study protocol was approved by institutional review board (IRB) and ethics committee of Shiraz University of Medical Sciences. All the recruited patients provided their informed written consents before inclusion in the study. We consecutively included all the patients younger than 40 years of age with traumatic pelvic fractures who underwent skin traction and were immobilized. The age limit of 40 was selected to lower the risk of interaction of natural process of resorption induced by aging. Patients with metabolic bone disease, patients with primary or metastatic bone tumor, patients on steroid, calcium or vitamin D supplements, and patients with abnormal baseline serum or urinary calcium level were excluded from the study. We also excluded those patients who were lost at follow-up during the initial 3 weeks of the study, those with renal insufficiency...

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…immobilized (12,13). Also the effect of immobilization on hypercalciuria and hypercalcemia at intermediate term has been studied (14).…”

mentioning

confidence: 99%

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Effect of immobilization on urine calcium excretion in orthopedic patients with pelvic fracture treated by skin traction

Derakhshan

Namazi

et al. 2015

Arch Ital Urol Androl

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“…The fact is that these patients are loading the arms through the use of crutches and wheelchairs and BMD values in the upper extremities are expected to be higher in relation to immobilized people (Quan et al, 1998). Subjects with MMC may have hypercalciuria associated with immobilization and an additional risk factor for osteoporosis in these patients group (Quan et al, 2003). Others support that low-energetic fractures in MMC children may result from metabolic disturbances that are a consequence of excessive renal calcium loss or excessive fatty tissue content (Okurowska-Zawada et al, 2009).…”

Section: Myelomeningocele and Cerebral Palsymentioning

confidence: 99%