Several clinical and epidemiological studies revealed increased bone turnover and lower bone mass in patients with
urolithiasis. Bone mass loss is particularly evident in idiopathic
calcium stone formers. However, pathogenetic mechanisms and factors implicated in bone loss in these patients are still unknown.
Dietary calcium restriction, increased intake of
salt and animal
proteins,
vitamin D receptor polymorphisms are likely risk factors, while role of inflammatory
cytokines,
osteopontin and
prostaglandin mediated
bone resorption is yet to be determined. Regarding treatment and prevention, it has been proven that
calcium supplements and high
calcium diet with the addition of
potassium alkali have an important role in prevention and treatment of both,
urolithiasis and
osteoporosis.
Thiazide diuretics reduce
hypercalciuria in renal tubules, and in addition promote osteoblast differentiation. Finally,
bisphosphonates, a commonly used drugs in treatment of
osteoporosis, show the potential to inhibit
calcium stone formation, whereas a possible protective effect of
antioxidants in bone loss and renal injurie needs to be investigated further.