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Longitudinal study of bone mineral density in children with idiopathic hypercalciuria

Maria Goretti Moreira Guimarães Penido1, Marcelo de Sousa Tavares, Mariana Campos Linhares

  • 1Pediatric Nephrology Unit, Clinics Hospital, School of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Santa Efigenia, Belo Horizonte, 30130100 Minas Gerais, Brazil. mariagorettipenido@yahoo.com.br

Pediatric Nephrology (Berlin, Germany)
|July 23, 2011
PubMed

Insights

Idiopathic hypercalciuria in children can lower bone mineral density (BMD). Treatment with potassium citrate and thiazides significantly improved BMD z-scores, suggesting a beneficial effect on bone health.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Idiopathic hypercalciuria (IH) in children is associated with reduced bone mineral density (BMD).
  • Optimal treatment strategies for pediatric IH and its impact on long-term bone health remain unclear.
  • Early intervention may be crucial for preventing potential bone complications in adulthood.

Purpose of the Study:

  • To evaluate the effect of potassium citrate and thiazide treatment on lumbar-spine BMD z-scores in pediatric patients with IH.
  • To assess changes in bone mineral density before and after a course of medical therapy.
  • To investigate the potential of treatment to mitigate negative impacts on bone health.

Main Methods:

  • Retrospective cohort study of 80 pediatric patients diagnosed with idiopathic hypercalciuria.
  • Dual-emission X-ray absorptiometry (DXA) used for bone scanning and densitometry.
  • Statistical analysis using t-tests and Mann-Whitney U tests to compare pre- and post-treatment BMD z-scores.

Main Results:

  • A significant improvement in lumbar-spine BMD z-score was observed, increasing from -0.763 ± 0.954 to -0.537 ± 0.898 (p < 0.0001).
  • Median calcium excretion decreased significantly from 5.0 to 2.6 mg/kg/24 h after treatment.
  • The study included 43 boys and 37 girls, followed for a median of 6.0 years.

Conclusions:

  • Treatment with potassium citrate and thiazides appears to be beneficial for improving bone mineral density z-scores in children and adolescents with idiopathic hypercalciuria.
  • These findings suggest a positive impact of the treatment regimen on bone health.
  • Further controlled studies are warranted to confirm these results due to the absence of a control group in this historical cohort.

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