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Bone mineral denisty and calcium metabolism in patients with urolithiasis

Aim: to evaluate the bone mineral density in patients with urolithiasis: those with hypercalciuria and others with normal calcium excretion and to compare the results with controls. The relation of bone mass with metabolic parameters in serum and twenty-four urine and dietary calcium intake was also explored. Materials and methods: 31 males with calcium urolithiasis and the control group of 15 males. Bone mineral density (BMD) on the lumbar spine (L2-L4), femoral neck and distal third of radius was measured. Basic anthropometric measurements were made and calcium intake was assessed by a dietary records. Serum and 24-hour urinary calcium, creatinine, magnesium, phosphorus, sodium, potassium, chloride, urea, uric acid were determined and also serum alkaline phosphatase, osteocalcin, calcitonin, parathyroid hormone and bone resorption markers. Results: hypercalciuric patients had significantly lower BMD on spine (p<0.05) and on radius (p<0.01) comparing to controls. Normocalciuric patients had significantly lower BMD of radius (p<0.05) than controls. Patients with urolithiasis had calcium metabolic parameters, including PTH, inside the reference values Significant correlations were found between BMD of spine and calcium urinary exretion (beta= -0.467 ; p=0.05), dietary calcium intake (beta=0.479 ; p=0.01) and telopeptide (beta=-0.550 ; p=0.01). Conclusion: increased calcium excretion is an important risk factor for low bone mineral density. Calcium-restricted diet in patients with urolithiasis could also have an important influence for decreased bone mass.

urolithiasis; bone mineral density; hypercalciuria; calcium intake

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