- 作者：M.脕. Arrabal-Polo ; M. Sierra Gir贸n-Prieto ; J. Orgaz-Molina ; A. Zuluaga-G贸mez ; S. Arias-Santiago ; M. Arrabal-Mart铆n
- 关键词：Calcium nephrolithiasis ; Bone mineral density ; Bone resorption ; Bone formation ; Urinary and bone markers
- 刊名：Actas Urol篓庐gicas Espa?olas (English Edition)
- 出版年：June, 2013
- 年：2013
- 卷：37
- 期：6
- 页码：362-367
- 全文大小：522 K
Context
Calcium nephrolithiasis is a multifactorial disease; in its pathophysiology is involved various minerals and metabolic factors that may be altered, including bone and phosphorus-calcium metabolism.Objective
To establish the scientific evidence and demonstrate the relationship between calcium nephrolithiasis and bone mineral density loss, through the use of bone turnover markers, serum and urinary metabolites.
Evidence acquisition
We performed a PubMed literature review using different MeSH Terms like 鈥淣ephrolithiasis鈥?鈥淏one mineral density鈥? 鈥淯rinary stones鈥? 鈥淐alcium鈥? 鈥淏one resorption鈥?and 鈥淏one formation鈥? with different combinations. We only selected articles with abstracts in English or Spanish and discarded clinical cases and articles with inappropriate statistical study. A total of 40 articles were selected.
Evidence synthesis
In different studies reviewed, it has been observed that patients with hypercalciuria have a higher bone mineral density loss with respect to normocalciuric. Among patients with calcium stones (normocalciuric or hypercalciuric), there is loss of bone mineral density, being more evident in patients with stones and hypercalciuria. This mineral density loss is marked and important in patients with recurrent calcium stones. Increased markers like fasting calcium/creatinine and 尾-CrossLaps are determinant of nephrolithiasis and mineral density loss in these patients.
Conclusion
We recommend performing markers of bone turnover and fasting calcium/creatinine in patients with recurrent calcium stones by the significant presence of bone mineral density loss, with a level of evidence III.