Bone Disease and Idiopathic Hypercalciuria

Abstract

There is sufficient epidemiological and clinical data demonstrating an association between reduced bone mineral density and idiopathic hypercalciuria (IH). There have been relatively few studies that have addressed the underlying defect in bone remodeling. The limited studies to date suggest that increased bone turnover occurs in some forms of IH such as fasting hypercalciuria or renal calcium leak and explains the bone loss observed in these forms of IH. On the other hand, defective bone formation is the major defect observed in patients with IH resulting from intestinal hyperabsorption of calcium. These alterations in bone remodeling have been ascribed to genetic, metabolic, and nutritional causes. Although there are several therapeutic options available for treating such patients and preventing stone recurrence, prevention of future bone loss should also be considered to prevent the increased risk of osteoporotic fracture in patients with IH.

Determinants of Osteopenia in Male Renal-Stone–Disease Patients with Idiopathic Hypercalciuria

“…The fact that these patients are relatively young emphasizes the importance of adequate predictive tools allowing early medical care in this population. Literature is conflicting about the efficiency of biologic markers of bone remodeling in renal-stone formers (5). Here, we studied osteocalcin, bone alkaline phosphatase, and urinary deoxypyridinoline, two markers of bone anabolism and one involved in bone catabolism, respectively.…”

“…Thus, the early recognition of patients at risk for osteopenia, before the occurrence of pathologic bone fractures, would be of clinical value. Indeed, because fractures occur after decades, most of observational and epidemiologic works are based upon bone mineral density (BMD) as a surrogate marker in renal-stone formers (4,5). However, BMD measurement in renal-stone formers is expensive and is currently not performed in routine practice, because urolithiasis affects more than 10% of the population in France and most Western countries (6,7).…”

“…However, BMD measurement in renal-stone formers is expensive and is currently not performed in routine practice, because urolithiasis affects more than 10% of the population in France and most Western countries (6,7). According to previous studies, hypercalciuria has been reported to be the major risk factor both for urolithiasis and bone-mass loss, thus raising the issue of whether a calcium homeostasis imbalance occurs not only in patients with a diagnosis of primary hyperparathyroidism but also in most patients with idiopathic hypercalciuria (5). The aim of this work was to study retrospectively the prevalence of osteopenia and to identify the biologic factors associated with a low BMD in a series of 65 idiopathic hypercalciuric renal-stone-disease male patients.…”

The epithelial sodium/proton exchanger, NHE3, is necessary for renal and intestinal calcium (re)absorption

“…The excretion of urine with an inappropriately high amount of Ca 2ϩ is referred to as hypercalciuria. This condition contributes to the development of osteoporosis and nephrolithiasis (49,52), diseases of Ca 2ϩ mishandling that have significant morbidity and socioeconomic impact.…”

Calcium renal lithiasis: metabolic diagnosis and medical treatment

“…It has been shown that the incidence of calcium renal lithiasis is higher in patients with losses of bone mineral density, while calciuria levels are also found to be high. 44 Some patients present genetic predisposition towards both calcium renal lithiasis and loss of bone mineral density. 45 Higher incidence of pathological fractures is also seen in osteoporosis patients with calcium renal lithiasis.…”