title: Bone demineralization following urinary intestinal diversion assessed by urinary pyridinium cross-links and dual energy x-ray absorptiometry.
abstract: OBJECTIVE
  We investigated the acid-base balance and bone mineral status in patients with 3 types of urinary intestinal diversion.
  
  
  METHODS
  Of 46 men with urinary intestinal diversions 20 had a Kock pouch, 15 had an Indiana pouch and 11 had an ileal conduit. Acid-base balance was assessed by arterial blood gas analysis. Bone mineral status was measured by urinary pyridinium cross-links and dual energy x-ray absorptiometry. In addition, urinary deoxypyridinoline was measured in 79 patients.
  
  
  RESULTS
  Of the 46 patients 7 (15%) with the Kock pouch (1), Indiana pouch (5) and ileal conduit (1) had metabolic acidosis associated with significantly lower bone mineral densities (p < 0.05) and higher urinary pyridinium cross-links (p < 0.005) than did those with normal acid-base status. No difference was found in metabolic acidosis and bone demineralization among the 3 groups. Additionally, in 79 patients urinary deoxypyridinoline reached the highest level immediately postoperatively and then gradually decreased to the stable level within 1 or 2 years.
  
  
  CONCLUSIONS
  Metabolic acidosis following urinary intestinal diversion results in bone demineralization. The types of diversion did not cause differences in metabolic acidosis and bone resorption. Bone has a major role in buffering acid overload in the early postoperative period.
authors.affiliation: Department of Urology, Faculty of Medicine, Kyoto University, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kawakita
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: C
authors.initials: C
authors.lastname: Shigeno
authors.forename: A
authors.initials: A
authors.lastname: Terai
authors.forename: Y
authors.initials: Y
authors.lastname: Okada
authors.forename: H
authors.initials: H
authors.lastname: Takeuchi
authors.forename: J
authors.initials: J
authors.lastname: Konishi
authors.forename: O
authors.initials: O
authors.lastname: Yoshida
mesh_terms: D015502:Absorptiometry, Photon; D000136:Acid-Base Equilibrium; D000138:Acidosis; D000368:Aged; D000596:Amino Acids / Q000652:urine; D018488:Bone Demineralization, Pathologic / Q000209:etiology* / Q000378:metabolism; D015519:Bone Density; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011726:Pyridinium Compounds / Q000097:blood*; D014547:Urinary Diversion / Q000009:adverse effects* / Q000379:methods
chemical_list: D000596:Amino Acids; D011726:Pyridinium Compounds; C036020:deoxypyridinoline