Prophylaxis against bone loss in Kock reservoir patients with reduced glomerular filtration rate.
OBJECTIVE
We investigated whether treatment with calcium carbonate and vitamin D3 can improve the bone mineral content of patients with ileal reservoirs for continent urinary diversion and a reduced glomerular filtration rate (GFR).


METHODS
Twenty-six patients with Kock reservoirs were included in the study. Bone mineralization was determined using dual-energy X-ray absorptiometry. Kidney function was estimated from Cr-EDTA clearance and serum cystatin C concentration. Osteocalcin and parathyroid hormone in serum were also measured. Patients with reduced GFR were treated with calcium carbonate and vitamin D3 perorally.


RESULTS
Bone mineral density in the femur neck and hip increased in the treatment group, as reflected by an improved T score.


CONCLUSIONS
Patients with ileal reservoirs for continent urinary diversion and reduced kidney function should be supplemented with calcium carbonate and vitamin D3 in order to reduce the long-term risk of osteoporosis.
Jonsson
Olof
O
Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden. olof.jonsson@vgregion.se
Herlitz
Hans
H
Lindholm
Elisabet
E
Lindstedt
Göran
G
Pazooki
David
D
Törnqvist
Harriet
H
Mellström
Dan
D
D015519:Bone Density; D002118:Calcium / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000627:therapeutic use*; D039021:Colonic Pouches; D055316:Cystatin C; D015891:Cystatins / Q000097:blood; D019587:Dietary Supplements; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control*; D016476:Urinary Reservoirs, Continent
C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D002762:Cholecalciferol; D002118:Calcium