The importance of calciuria as lithogenic factors in patients with osteopenia/osteoporosis.

Abstract

PURPOSE:

Recurrent kidney stones are associated with bone mineral density loss, altered bone remodeling markers, hypercalciuria and increased in fasting calcium/creatinine ratio. The objective was to determine biochemical alterations in urine in patients with osteopenia/osteoporosis without calcium kidney stones compared with patients with calcium kidney stones.

METHODS:

This is a cross-sectional study including 142 patients who were divided in two groups: Group 1 (patients with recurrent calcium kidney stones) and Group 2 (patients with osteopenia/osteoporosis in the lumbar spine or hip). Analyses of bone mineral density, calcium-phosphorous and bone metabolism and lithogenic risk factors in fasting urine samples and 24-h urine samples were performed. Statistical analysis was carried out with SPSS 17.0. A p ≤ 0.05 was considered statistically significant.

RESULTS:

Patients in Group 2 presented greater loss of bone mineral density and more elevated alkaline phosphatase, iPTH, phosphorous and β-crosslaps levels, as compared to patients in Group 1. However, Group 1 presented greater urine calcium, oxalate and uric acid and a higher proportion of hypocitraturia, hypercalciuria and hyperoxaluria, as compared to Group 2. Multivariate analysis revealed that advanced age and β-crosslaps levels are risk factors for bone mineral density loss, while low urinary calcium excretion was protective against bone demineralization.

CONCLUSION:

Patients with osteopenia/osteoporosis without lithiasis present some urinary biochemical alterations. This would explain the lack of lithogenic activity, although low calcium excretion in 24-h urine samples is a protective factor against the loss of bone mineral density.

• Authors: Miguel Arrabal-Martin, Antonio Poyatos-Andujar, María del Carmen Cano-García, Miguel Quesada-Charneco, Felix Abad-Menor, María Sierra Girón Prieto, Tomás de Haro Muñoz, Miguel Angel Arrabal-Polo
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 47 Issue 3 Pg. 445-9 (Mar 2015) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 25652872 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Parathyroid Hormone
• Peptide Fragments
• glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine
• Uric Acid
• Phosphorus
• Collagen
• Oxalic Acid
• Alkaline Phosphatase
• Calcium

Topics

• Adult
• Age Factors
• Alkaline Phosphatase (urine)
• Bone Density
• Bone Diseases, Metabolic (complications, urine)
• Calcium (urine)
• Case-Control Studies
• Collagen (urine)
• Cross-Sectional Studies
• Female
• Humans
• Hypercalciuria (complications, urine)
• Kidney Calculi (etiology, urine)
• Male
• Middle Aged
• Osteoporosis (complications, urine)
• Oxalic Acid (urine)
• Parathyroid Hormone (urine)
• Peptide Fragments (urine)
• Phosphorus (urine)
• Recurrence
• Uric Acid (urine)