Increased Prevalence of Nephrolithiasis and Hyperoxaluria in Paget Disease of Bone

Abstract

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.

Diagnosis and Management of Osteoporosis During COVID-19: Systematic Review and Practical Guidance

“…This study showed that VF’s were common (about 36%) among those hospitalised with severe SARS Cov2 compared with the general population where the prevalence of VFs ranged from 18–26% in women and 8–20% in men. The presence of VFs in this study was a strong prognostic marker and predictor of clinical outcomes and disease severity as other well-described risk factors and co-morbidities, although the prevalence of VFs in the study population was higher than previously reported in the European general populations [ 43 , 44 ]. Furthermore, patients with VFs were more likely to require non-invasive mechanical ventilation (48.8% vs 27.4%, p = 0.02).…”

“…Furthermore, patients with VFs were more likely to require non-invasive mechanical ventilation (48.8% vs 27.4%, p = 0.02). Mortality was higher in those with severe VFs (60%) compared with those with moderate or mild VFs (7% and 24%, respectively) [ 43 ]. The author speculated that impaired respiratory function and kyphosis associated with VF’s may decrease vital lung capacity and increase the risk of severe SARS Cov2 infection.…”

Idiopathic Osteoporosis and Nephrolithiasis: Two Sides of the Same Coin?

“…Noteworthy, a Cochrane meta-analysis did not indicate an increased risk of hypercalcemia, hypercalciuria or nephrolithiasis in patients with vitamin D deficiency treated with cholecalciferol [119]. Moreover, the correction of vitamin D deficiency with cholecalciferol in patients with Paget's disease of the bones, who are at increased risk of nephrolithiasis [120], did not cause either an increase in supersaturation indices of calcium-oxalate and calcium-phosphate salts or a rise in urinary pH and urinary excretion of urate, the major risk factors for calcium and urate nephrolithiasis, respectively [121].…”

Is a Patient with Paget’s Disease of Bone Suitable for Living Kidney Donation?—Decision-Making in Lack of Clinical Evidence

“…Metabolic complications of PDB include hypercalcemia, hypercalciuria, hyperoxaluria, and hyperuricemia [ 43 ]. Disturbances in calcium homeostasis can lead to kidney stone formation and nephrolithiasis (NL), the most frequent kidney complication of PDB [ 47 ]. NL has been described as a possible non-malignant metabolic complication of PDB [ 43 ].…”

“…This association remained significant also in a model adjusted for age, sex, BMI, and eGFR [OR 2.26 95% C.I. : 1.72–2.98, p < 0.01] [ 47 ]. The rate of recurrence of NL was higher in the polyostotic group than in the monostotic group of patients with PDB.…”