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Related Experiment Videos

Reduced vertebral bone density in hypercalciuric nephrolithiasis.

F Pietschmann1, N A Breslau, C Y Pak

  • 1Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|December 1, 1992
PubMed
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Patients with absorptive and fasting hypercalciuria show significantly lower bone density, particularly in the lumbar spine. Environmental factors like sodium intake may contribute to bone loss in absorptive hypercalciuria.

Area of Science:

  • Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Hypercalciuria, a condition characterized by elevated calcium levels in urine, is a known risk factor for kidney stone formation.
  • The relationship between hypercalciuria and bone density, particularly in different subtypes of hypercalciuria, requires further investigation.

Purpose of the Study:

  • To compare bone mineral density (BMD) at the lumbar spine and radial shaft in patients with absorptive hypercalciuria, fasting hypercalciuria, and nonhypercalciuric stone formers.
  • To investigate the association between urinary chemistry, body mass index, and bone density in patients with absorptive hypercalciuria.

Main Methods:

  • Dual-energy x-ray absorptiometry (DXA) and single-photon absorptiometry were employed to measure bone density.
  • Sixty-two patients with absorptive hypercalciuria, 27 with fasting hypercalciuria, and 31 controls were included in the study.
Keywords:
NASA Discipline Regulatory PhysiologyNon-NASA Center

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  • Urinary chemistry, including 24-hour excretion of calcium, uric acid, sodium, and sulfate, along with urinary pH, was analyzed.
  • Main Results:

    • Lumbar spine bone density was significantly lower in both absorptive (-10%) and fasting hypercalciuria (-12%) groups compared to controls.
    • A higher percentage of patients with absorptive (74%) and fasting hypercalciuria (92%) exhibited below-normal bone density values.
    • Radial bone density did not differ significantly across the groups, while absorptive hypercalciuria patients with lower bone density showed increased urinary calcium and uric acid excretion and higher BMI.

    Conclusions:

    • Fasting and absorptive hypercalciuria are associated with osteopenia, predominantly affecting trabecular bone in the lumbar spine.
    • Environmental factors, including high sodium and animal protein intake, may play a role in the pathogenesis of bone loss in absorptive hypercalciuria.
    • Urinary chemistry and body mass index are potential contributing factors to reduced bone density in hypercalciuric patients.