Particularities of Bone Metabolism and Calcium Regulators in a Group of Young Males with Idiopathic Hypercalciuria and Relapsing Kidney Lithiasis

Abstract

Background. Idiopathic hypercalciuria is a risk factor for nephrolithiasis. Both renal stones and hypercalciuria are associated with lower bone mineral density (BMD), but the relationship between these modifications is not completely understood.Aims. To evaluate some metabolic particularities possibly related to relapsing nephrolithiasis (RN) in young male patients.Methods. We performed a crosssectional study including a group of 30 young male patients with RN and a group of 30 healthy, age and BMI (body mass index) matched controls (CTR). We evaluated calcium and phosphate metabolism, bone remodeling markers alkaline phosphatase (AP) and osteocalcin in serum and 24-hour urine samples, and lumbar and hip BMD.Results. We observed higher values of serum calcium (P<0.05) and 24 hour urinary calcium (P<0.001) in the RN group. Parathyroid hormone (PTH) and AP were also higher in the RN group (P<0.01), whereas serum 25OH-D 3 was lower (P<0.01). BMD, T and Z scores were lower in the RN group in both the lumbar (P<0.01) and hip (P<0.05) regions. Conclusions.Young male patients with hypercalciuric RN have lower BMD and higher bone turnover. Higher PTH levels related to vitamin D deficiency may contribute to bone demineralization in certain cases.

Nephrolithiasis, bone mineral density, osteoporosis, and fractures: a systematic review and comparative meta-analysis

“…Hip BMD was also reduced across four [28,33,35,43] (SMD = −0.82, p < 0.0001; I 2 = 32 %) reporting data on Z-scores (Table 1).…”

“…Regarding hip BMD, across seven studies [27,28,33,35,43,51,54], T-scores were significantly reduced in people with nephrolithiasis (SMD = −0.82; 95 % CI = −1.11 to −0.52; p < 0.0001; I 2 = 72 %). Hip BMD was also reduced across four [28,33,35,43] (SMD = −0.82, p < 0.0001; I 2 = 32 %) reporting data on Z-scores (Table 1).…”

The variation in urinary calcium levels in adult patients with fracture and surgical intervention

“…It was the same in our results. The relationship between low BMD and hypercalciuria is that lower serum calcium can stimulate the secretion of parathyroid hormones to release calcium [ 28 ]. There is no evidence for a difference between genders in the change in urine calcium levels during the fracture healing period.…”