Incidence of Osteoporosis in Patients with Urolithiasis

Abstract

Introduction.Clinical researches have shown an increased bone disintegration and lower bone mass in patients with calcium urolithiasis.Goal.The goal of our research was to establish the incidence of osteoporosis in adult patients with calcium urolithiasis, on the basis of measuring mineral bone density, using DEXA method, with a special reflection on age subgroups.Material and methods.Clinical research was prospective and it was implemented at the University Clinical Center of Banja Luka, at the Clinic for Endocrinology, Diabetes and Metabolic Diseases and at the Urology Clinic. Material in this research consisted of patients divided in two groups, a working and a control group. One hundred and twenty (120) patients were included in both these groups, divided in three age subgroups: 20-40, 40-60 and over 60. The working group consisted of the patients with calcium urolithiasis and the control group consisted of patients without calcium urolithiasis. Establishing of mineral bone density at L2-L4 of lumbal spine vertebrae and hip was done for the patients in both these groups, using DEXA method.Results.Analysis of mineral bone density using DEXA method in patients in age groups of working and control groups, as well as in the total sample of working and control groups, have shown that the patients of the working group, over 60, had a decreased mineral bone density (30% of osteopenia and 15% osteoporosis) significantly more expressed when compared to the other two age groups (12.5% in the subgroup 20-40 and 17.5% in the subgroup 40-60), which presents a statistically significant difference (p<0.05). In the control group, when taking into account age groups, osteopenia and osteoporosis were marked in 37.5% and 2.5% in the group of patients over 60, whereas in the youngest population, 5% of osteopenia was found, which presents a statistically significant difference (p<0.05). When observing the total sample of working and control group, there was a statistically significant difference in the working and control group (p<0.01); incidence of osteoporosis in the working group amounted to 7.5% and in the control group it was 0.8%.Conclusion.Urolithiasis and osteoporosis are two multifactorial diseases which are evidently reciprocal. This is why we suggest that educating the population about the risk factors for occurrence of these diseases as well as preventive measures that may contribute to their decrease should begin as early as possible.

Nephrolithiasis, bone mineral density, osteoporosis, and fractures: a systematic review and comparative meta-analysis

“…Bijelic et al [53] found an increased risk of incident osteoporosis (7.5 vs. 0.8 %) in patients with renal stones compared to controls. On the contrary, Melton et al [4] found contrasting findings on incident fractures in patients with urolithiasis compared with the expected number of fractures, since patients with kidney stones experienced a higher rate of vertebral, but lower of hip fractures than those expected.…”

“…Two longitudinal studies [4,53] were summarized as descriptive findings. Bijelic et al [53] found an increased risk of incident osteoporosis (7.5 vs. 0.8 %) in patients with renal stones compared to controls.…”

Urine Calcium and Bone Mineral Density in Calcium Stone-Forming Patients Treated with Alendronate and Hydrochlorothiazide

“…The use of thiazides is not always sufficient, as it has been demonstrated that a high percentage of patients with recurrent renal calcium stones have an osteopenia/osteoporosis [20,21,22] that could benefit from treatment with an anti-reabsorption drug. The bisphosphonates are a group of therapeutic drugs widely used in the treatment of osteoporosis [23], although they are not free of adverse effects, one of the most severe being osteonecrosis of the jaw.…”

The Importance of Urinary Calcium in Postmenopausal Women With Osteoporotic Fracture

“…9 It is well known that patients with hypercalciuria and fasting hypercalciuria have more risk of bone mineral density loss, 13 and that calcium renal stones and osteopenia/osteoporosis are two related and reciprocal diseases. 14 The role of urinary calcium in the physiology of stones is very important, due to the main metabolic risk factor found in patients with lithiasis. 9 The study of calciuria is recommended in women with osteoporosis and osteoporotic fracture.…”