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Diphosphonate therapy in nephrocalcinosis

D A McCredie, H R Powell, E Rotenberg

    British Journal of Urology
    |April 1, 1976
    PubMed
    Summary
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    Disodium ethane 1-hydroxy-1, 1-diphosphonate (EHDP) showed dubious value in treating nephrocalcinosis, despite preventing crystal deposition in some patients. Side effects like defective bone mineralization and secondary hyperparathyroidism were observed.

    Area of Science:

    • Nephrology
    • Pediatric Endocrinology
    • Bone Metabolism

    Background:

    • Nephrocalcinosis is a condition characterized by calcium deposits in the kidneys.
    • Disodium ethane 1-hydroxy-1, 1-diphosphonate (EHDP) is a bisphosphonate used to inhibit calcification.
    • The efficacy and safety of EHDP in pediatric nephrocalcinosis require further investigation.

    Purpose of the Study:

    • To evaluate the clinical and histological effects of EHDP in children with nephrocalcinosis.
    • To assess the impact of EHDP on crystal deposition, bone mineralization, and secondary hyperparathyroidism.

    Main Methods:

    • A cohort of 4 patients with nephrocalcinosis was treated with EHDP for 13 months.
    • Clinical observations, radiographic assessments, and bone biopsies were performed.

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    Main Results:

    • No clinical side effects or growth impairment were observed during the 13-month treatment period.
    • Radiographic evidence of osteitis fibrosa cystica developed in one child, and bone biopsies revealed defective osteoid mineralization in two children.
    • EHDP appeared to prevent further crystal deposition in three patients but did not prevent non-calcium stone formation in the fourth patient.

    Conclusions:

    • The overall value of EHDP in treating nephrocalcinosis is questionable due to observed bone abnormalities and secondary hyperparathyroidism.
    • EHDP may be considered in specific cases of rapidly increasing calcification, such as in hyperoxaluria, but its use warrants caution.