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  • Title: Bone density and skeletal metabolism are altered in idiopathic hypercalciuria.
    Author: Giannini S, Nobile M, Sartori L, Calò L, Tasca A, Dalle Carbonare L, Ciuffreda M, D'Angelo A, Pagano F, Crepaldi G.
    Journal: Clin Nephrol; 1998 Aug; 50(2):94-100. PubMed ID: 9725780.
    Abstract:
    OBJECTIVE: To study bone density in hypercalciuric patients, when classified according to the main metabolic defect. METHODS: We studied 49 patients, aged 19-60 years with calcium stones and idiopathic hypercalcuria. All subjects underwent an evaluation of mineral metabolism and a spinal and femoral DEXA measurement. Then, patients were classified as having Fasting (FH, 31 subjects) or Absorptive (AH, 18 patients) Hypercalciuria according to a standard oral calcium load. RESULTS: Spinal bone density was lower only in FH patients as compared to controls (p <0.001). Bone alkaline phosphatase and urine hydroxyproline were higher with respect to controls only in patients with FH (p <0.005 and p <0.015, respectively). After low calcium diet, hydroxyproline excretion continued to be higher in FH patients (p <0.05). Although in the normal range, serum and urine uric acid were higher in hypercalciuric subjects (p <0.03 and p <0.005, respectively); blood pH was lower in hypercalciuric patients than in controls (p <0.01). In FH patients urine hydroxyproline negatively correlated with spinal and femoral density (p <0.001 and p <0.005, respectively), and blood pH positively correlated with spinal density. CONCLUSIONS: a disordered bone metabolism and bone loss are present only in patients with fasting hypercalciuria. An excessive acid load, possibly of dietary origin, might be involved as a pathogenetic factor.
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