Evolution of bone mineral density in patients with idiopathic hypercalciuria: a 20-year longitudinal study
| Autor: | Elena Sánchez Almeida, Ma Isabel Luis Yanes, German Perez-Suarez, Maria Cecilia Martín Fernández de Basoa, Víctor Manuel García Nieto |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Longitudinal study Hypercalciuria 030232 urology & nephrology Urology chemistry.chemical_element 030204 cardiovascular system & hematology Calcium Citric Acid Bone resorption Excretion 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Bone Density Internal medicine medicine Humans Citrates Longitudinal Studies Child Bone mineral Creatinine business.industry chemistry Child Preschool Pediatrics Perinatology and Child Health Female Densitometry business |
| Zdroj: | Pediatric Nephrology. 36:661-667 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s00467-020-04754-6 |
| Popis: | Several recent studies reported bone mineral density (BMD) reduction in pediatric patients with idiopathic hypercalciuria (IH). This longitudinal study aimed to evaluate BMD evolution in IH patients through three bone densitometry studies conducted over 20 years on average. A second objective was to evaluate urine calcium and citrate excretion during this period. Case notes of 34 patients diagnosed with IH at age 7.9 ± 3, alongside results of two bone densitometry studies, performed at 10.5 ± 2.7 (BMD1) and 14.5 ± 2.7 (BMD2) years of age, were reviewed. Patients underwent a third densitometry study in adulthood (BMD3) aged 28.3 ± 2.9. Mean follow-up duration (time-lapse between BMD1 and BMD3) was 17.7 ± 1.4 years. Statistically significant differences were found between z-BMD3 (− 0.85 ± 1.10) and z-BMD1 (− 1.47 ± 0.99) (P = 0.001) as well as between z-BMD3 and z-BMD2 (− 1.33 ± 1.20) (P = 0.016). At the end of follow-up, z-BMD3 was superior to z-BMD2 in 23 adult patients (67.6%) and lower in 11 patients (5M, 6F; 32.3%). Both men and women showed increased bone mass over time, although such increases were significant only for women. The gradual decrease observed in calcium/creatinine and citrate/creatinine ratios could be related to improvement in osteoblastic activity and especially reduction in osteoclastic activity. In patients with IH, BMD improves, which may be related especially to female sex, increment of body mass, and reduction in bone resorption. Upon reaching adulthood, urine calcium and citrate excretion tend to decrease so lithogenic risk still remains. The cause of the latter is unknown, although it likely relates to changes in bone activity. |
| Databáze: | OpenAIRE |
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