Low bone density in children with hypercalciuria and/or nephrolithiasis

Area of Science:

• Pediatric Nephrology
• Bone Metabolism
• Urolithiasis Research

Background:

• Hypercalciuria and nephrolithiasis are common in children.
• Low bone density is a concern in pediatric populations.
• The relationship between these conditions and bone health is not fully understood.

Purpose of the Study:

• To determine the prevalence of low bone density in children with hypercalciuria and/or nephrolithiasis.
• To investigate if 24-hour urine stone-risk profiles and growth parameters can predict low bone density.
• To analyze differences in bone density based on clinical presentation (hypercalciuria vs. nephrolithiasis).

Main Methods:

• Retrospective chart review of 110 pediatric patients with idiopathic hypercalciuria and/or kidney stones.
• Collected data included 24-hour urine stone-risk profiles and dual-energy X-ray densitometry (DXA) scans.
• Patients were categorized into low vs. normal bone density groups and hypercalciuria vs. nephrolithiasis groups for analysis.

Main Results:

• Overall, 47% of patients had a bone density z-score < -1, and 26% had a z-score < -2.
• Children with low bone density showed higher body mass index and lower urine creatinine and ammonium levels.
• Nephrolithiasis patients exhibited lower bone density z-scores compared to those with hypercalciuria alone.

Conclusions:

• A significant proportion of children with hypercalciuria and/or nephrolithiasis present with low bone density.
• Clinicians should consider bone density screening in pediatric patients with these conditions.
• Further research is needed to understand the impact of treatment on bone density and its long-term progression.