1.Metabolic-mineral study in patients with renal calcium lithiasis, severe lithogenic activity and loss of bone mineral density.
Miguel Angel ARRABAL-POLO ; Miguel ARRABAL-MARTIN ; Salvador ARIAS-SANTIAGO ; Juan GARRIDO-GOMEZ ; Tomas De De HARO-MUÑOZ ; Armando ZULUAGA-GOMEZ
Singapore medical journal 2012;53(12):808-813
INTRODUCTIONThis study assessed the presence of osteoporosis/osteopenia in patients with severe lithogenic activity and compared their metabolisms with those in patients without lithiasis or with mild lithogenic activity.
METHODSFrom a sample of 182 patients, those with osteopenia/osteoporosis at the hip and lumbar spine were studied separately in a two-pronged study. 66 patients with bone mineral densities (BMDs) < -1 standard deviation (SD) on a T-score scale at the hip were divided into three groups: group A1 without lithiasis (n = 15); group A2 with lithiasis and mild lithogenic activity (n = 22); and group A3 with lithiasis and severe lithogenic activity (n = 29). Similarly, 86 patients with BMDs < -1 SD on a T-score scale at the lumbar spine were divided into three groups: group B1 without lithiasis (n = 15); group B2 with lithiasis and mild lithogenic activity (n = 29); and group B3 with lithiasis and severe lithogenic activity (n = 42).
RESULTSPatients from group A3 exhibited significantly higher levels of bone remodelling markers as compared to groups A1 and A2. Urinalysis also revealed higher excretion of calcium in 24-hour assessments in this group. Patients from group B3 differed from groups B1 and B2 mainly in bone remodelling markers and 24-hour urinary calcium excretion, which were significantly elevated in patients from group B3.
CONCLUSIONPatients with calcium lithiasis and severe lithogenic activity in addition to osteopenia/osteoporosis present with higher levels of hypercalciuria and negative osseous balance, which possibly perpetuate and favour lithiasic activity.
Absorptiometry, Photon ; Adult ; Bone Density ; Bone Remodeling ; Calcium ; urine ; Cross-Sectional Studies ; Female ; Humans ; Hypercalciuria ; complications ; metabolism ; Incidence ; Lumbar Vertebrae ; diagnostic imaging ; Male ; Middle Aged ; Nephrolithiasis ; complications ; metabolism ; Osteoporosis ; epidemiology ; etiology ; metabolism ; Risk Factors ; Severity of Illness Index ; Spain ; epidemiology