Bone involvement in idiopathic hypercalciuria
A.M. Misael da Silva, L.M. dos Reis, R.C. Pereira, E. Futata, C.T. Branco-Martins, I.L. Noronha, B.L. Wajchemberg, V. Jorgetti
1 Nephrology Division, 2 Immunology Division, and 3 Endocrinology Division, University of São Paulo Medical School, São Paulo, Brazil
DOI 10.5414/CNP57183
Abstract
Background: To evaluate bone involvement in idiopathic hypercalciuria, 40 lithiasic patients and 10 controls were studied. Methods: According to urinary calcium excretion, patients were first classified as hypercalciuric (Hca, n = 22) and normocalciuric (Nca,n = 18). The Hca patients were then subclassified according to bone densitometry (BMD) as osteopenic (HcaO, n = 10) and non-osteopenic(HcaNO,
n = 12). Routine biochemistry, dietary records, bone histomorphometry, and cytokines (IL-1b, IL-6, and TNF) production
by peripheral blood mononuclear cell cultures were studied. Results: There were no differences in routine biochemistry between Hca and Nca groups
except for urinary calcium. Inadequate nutrition was observed in Hca group,showing high protein (80.9% of the patients), carbohydrate (76.2%) and sodium (90%) intake. Calcium intake was low in Hca (57%) and Nca (83%) groups. IL-6 and TNF were not different between the Hca and Nca groups. IL-1b levels were significantly high in both groups when compared to controls. IL-6 and TNF were higher in HcaO than Nca. BMD in femoral neck in HcaO was lower than in HcaNO and Nca groups. Eroded surface (ES/BS) increased in 91% of the Hca group and 36% had a mineralization defect. In the HcaO group serum PTH
correlated negatively with trabecular bone volume (BV/TV) and positively with ES/BS.
1,25(OH)2D3 levels correlated positively with osteoblastic surface.
Calcium intake correlated positively with BV/TV and inversely with ES/BS. A negative
correlation was observed between IL-6 levels and Z score of the femoral neck. Conclusion:Bone involvement was detected in a young population with nephrolithiasis demonstrating that a strict follow-up is necessary in order to control hypercalciuria.
Author Details
Authors
Departments
- 1 Nephrology Division,
- 2 Immunology Division, and
- 3 Endocrinology Division, University of São Paulo Medical School, São Paulo, Brazil
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Citation
A.M. Misael da Silva, L.M. dos Reis, R.C. Pereira, E. Futata, C.T. Branco-Martins, I.L. Noronha, B.L. Wajchemberg and V. Jorgetti.Bone involvement in idiopathic hypercalciuria. 2002; 57: 183-191. doi: 10.5414/CNP57183.
