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Lipid disturbances have been linked to the progression of chronic renal disease. We examined 52 patients with a creatinine clearance (CCr) of 38.5 ± 7.9 ml/min due to various nephropathies, on free diet. Bimonthly, over a 12-month period, we assessed: serum creatinine (Cr); CCr; daily urinary urea excretion; urinary protein excretion per unit of residual renal function (UProt/CCr); total, HDL, VLDL and LDL cholesterol; triglycerides; Apo A, Apo B. Chronic renal failure was progressive in 22 patients with a slope of 1/Cr-0.00358 ± 0.00247, stable in 30 with a slope of 0.00420 ± 0.00285. Lipid parameters did not differ significantly between the two groups but for the lower Apo A and Apo A/Apo B ratio values in the progressive group. Overall slope inversely correlated with basal CCr; in the progressive patients the slope correlated with the percentage variation of UProt/CCr and only partially with the altered Apo profile.

Osteoporosis and nephrolithiasis are common multifactorial disorders with high incidence and prevalence in the adult population worldwide. Both are associated with high morbidity and mortality if not correctly diagnosed and accurately treated. Nephrolithiasis is considered a risk factor for reduced bone mineral density. Aim of this retrospective longitudinal study was to evaluate if osteoporosis is a predictive factor for the nephrolithiasis occurrence. Free-living subjects referring to “COMEGEN” general practitioners cooperative operating in Naples, Southern Italy. Twelve thousand seven hundred ninety-four Caucasian subjects (12,165 female) who performed bone mineral density by dual-energy X-ray absorptiometry and have a negative personal history for nephrolithiasis. Subjects aged less than 40 years or with signs or symptoms suggestive of secondary osteoporosis were excluded from the study. In a mean lapse of time of 19.5 months, 516 subjects had an incident episode of nephrolithiasis. Subjects with osteoporosis had an increased risk of nephrolithiasis than subjects without osteoporosis (Hazard Ratio = 1.33, 95% Confidence Interval 1.01–1.74, p = 0.04). Free-living adult subjects over the age of 40 with idiopathic osteoporosis have an increased risk of incident nephrolithiasis, suggesting the advisability of appropriate investigation and treatment of the metabolic alterations predisposing to nephrolithiasis in patients with osteoporosis. The study protocol was approved by the ASL Napoli 1 Ethical Committee, protocol number 0018508/2018

Context Nephrolithiasis (NL) and primary hyperparathyroidism (HPTH) are metabolic complications of Paget’s Disease of Bone (PDB), but recent data regarding their prevalence in PDB patients are lacking. Objectives Study 1: To compare the prevalence of primary HPTH and NL in 708 PDB patients and in 1803 controls. Study 2: To evaluate the prevalence of NL-metabolic risk factors in 97 PDB patients with NL, 219 PDB patients without NL, 364 NL patients without PDB and 219 controls, all of them without HPTH Design Cross-sectional multicentric study Setting Italian referral Centers for metabolic bone disorders Participants PDB patients from the AIP (Associazione Italiana malati di osteodistrofia di Paget) registry. Participants to the Olivetti Heart and the Siena Osteoporosis Studies Main Outcome Measures HPTH; NL; NL-metabolic risk factors Results PDB patients showed higher prevalence of primary HPTH and NL compared to controls (p&0.01). The NL recurrence occurs more frequently in patients with polyostotic PDB. About half of PDB patients without NL showed one or more NL-related metabolic risk factors. The hyperoxaluria (HyperOx) prevalence was higher in PDB patients with NL compared to NL patients without PDB and in PDB patients without NL compared to controls (p=0.01). PDB patients with HyperOx showed a longer lapse of time from the last aminobisphosphonate treatment. Conclusions NL and HPTH are frequent metabolic complication of PDB. The NL occurrence should be evaluated in PDB patients, particularly in those with polyostotic disease and/or after aminobisphosphonate treatment, in order to apply an adequate prevention strategy.