Bone mineral density in pediatric patients with idiopathic hypercalciuria

García‐Nieto, Victor; Ferrández, C.; Monge, Margarita; Sequera, Miren; Rodrigo, Mahinda

doi:10.1007/s004670050341

Cited by 73 publications

(76 citation statements)

References 33 publications

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“…One of the more important questions to be answered is whether adult osteoporosis is initiated during childhood in children with IH due to a failure in reaching adult peak bone mass values. In a previous study, our group determined that 30% of the 73 hypercalciuric children investigated showed signs of osteopenia [2]. This association of osteopenia and IH was later confirmed by Freundlich et al [3], Penido et al [4], and Schwaderer et al [5], who respectively reported that 38, 37, and 47% of the IH children studied showed a significant decrease in BMD.…”

Section: Introductionsupporting

confidence: 70%

Effect of thiazides on bone mineral density in children with idiopathic hypercalciuria

et al. 2011

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To determine the effect of thiazide treatment on bone mineral density (BMD) in children with idiopathic hypercalciuria (IH) and osteopenia, we reviewed the case notes of 22 children aged 11.7 ± 2.7 years diagnosed with IH and osteopenia who had received thiazides for 2.4 years. The data on this group were compared with those of 32 IH children with osteopenia aged 11.2 ± 2.7 years who had not received thiazide treatment. By the end of the follow-up period, the z-BMD had improved spontaneously in 23 of the 32 control children (72%) and in 12 of the 22 patients on thiazides (54%). Although treated patients had a higher body mass index (BMI) and a higher BMD following treatment, the differences became statistically negligible when these parameters were expressed as z-BMD or as bone mineral apparent density (BMAD). In contrast, within the control group, there were significant differences in BMAD and z-BMD at the end of the follow-up. Patients who had an improved z-BMD at the end of the treatment also showed an increase in their BMI. Based on these results, we conclude that thiazide treatment does not improve the z-BMD in children with IH. More than half of the children suffering from IH enrolled in our study showed a spontaneous improvement in their z-BMD, which was more evident when the initial BMAD was not low and when their BMI increased during the follow-up period.

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Section: Introductionsupporting

confidence: 70%

Effect of thiazides on bone mineral density in children with idiopathic hypercalciuria

et al. 2011

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“…The prevalence of this disorder in children with IH has been estimated to be up to 38% [6]. In a previous study we reported diminished BMD at the spinal site in 30% of patients [5], whereas in the present study, a Z-score <–1 was found in 42.5% of girls with IH. With respect to the mothers in our study, all had IH.…”

Section: Discussioncontrasting

confidence: 50%

“…Several studies in the last few years have also reported a reduction of BMD in pediatric patients with IH [5, 6, 7]. Although it is well documented that environmental factors contribute to BMD, family studies have shown that genetic factors may also play an important role in determining bone mass [8, 9, 10].…”

Section: Introductionmentioning

confidence: 99%

Bone Mineral Density in Girls and Their Mothers with Idiopathic Hypercalciuria

et al. 2004

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Background/Aims: Idiopathic hypercalciuria (IH) is associated with a decreased bone mineral density (BMD) both in children and adults. It is being increasingly recognized that IH may be a contributing factor to osteopenia and/or osteoporosis in adults. We studied BMD in girls with IH and in their mothers, also affected with IH, in order to evaluate the influence of genetic background on bone mass in the setting of IH. Methods: BMD was evaluated in 40 girls with IH and in their premenopausal mothers from whom they had inherited this disease. Urinary creatinine and calcium were measured by standard laboratory methods. BMD was determined by dual X-ray absorptiometry scanning of the lumbar spine (LS) and the femoral neck (FN), and values are expressed as Z- and T-scores. Results: A Z-score of <–1 at the LS was found in 42.5% of the girls, whilst in the mothers, a Z score of <–1 at the LS and/or FN was observed in 47.5% and a T-score of <–1 at the LS and/or FN in 62.5%. The Z-score at the LS was significantly lower in girls and their mothers compared to controls, although this finding did not apply for the Z-score at the FN in the mothers. Z-scores in the girls of mothers with osteopenia were significantly lower or there was a trend for the score to be lower than in the girls of mothers with normal BMD. There was a significant relationship between the Z-score of the girls and the T-score at the LS in the mothers (r = 0.32, p < 0.05). Conclusion: We have observed a high prevalence of osteopenia in our population affected by IH, both in girls and in their mothers. We suggest that BMD should be measured during the third or fourth decades of life in those individuals with nephrolithiasis or with children diagnosed as having IH.

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“…However, alterations in childhood bone mass acquisition may not affect bone mass many decades later in late adulthood because there is a homeostatic system that tends to return to a set point after any transient perturbation [52] . Thus, workup of idiopathic hypercalciuria necessarily involves the investigation of bone mineral metabolism and the characterization of the profile of bone changes, so the physician can act objectively in prevention and treatment [40,42,43,53] . Obesity associated with metabolic syndrome is a known risk factor for UL in adults, however, this association is not well established in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

Penido

Tavares

2015

WJN

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In the past few decades pediatric urolithiasis has become more frequent. The reason for this increase is not completely clear but has been attributed to changes in climate, nutritional habits and possibly other environmental factors. Although less frequent than adult stone disease, urolithiasis in the pediatric age group is also related to significant morbidity, particularly since stones tend to recur, and, thus, should not be underestimated. Most children with idiopathic stone disease have an underlying metabolic abnormality substantiating the importance of metabolic evaluation already following initial diagnosis of urolithiasis. Identification of the metabolic abnormality allows for more specific prescription of non pharmacological and pharmacological interventions aimed at preventing recurrent stone formation. A better understanding of the causes of kidney stone disease will provide better strategies for stone prevention in children.

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Bone mineral density in pediatric patients with idiopathic hypercalciuria

Cited by 73 publications

References 33 publications

Effect of thiazides on bone mineral density in children with idiopathic hypercalciuria

Effect of thiazides on bone mineral density in children with idiopathic hypercalciuria

Bone Mineral Density in Girls and Their Mothers with Idiopathic Hypercalciuria

Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

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