title: Calcium renal lithiasis and bone mineral density. Importance of bone metabolism in urinary lithiasis.
abstract: BACKGROUND
  Calcium Nephrolithiasis is a multifactorial disease; in its pathophysiology is involved various minerals and metabolic factors that may be altered, including bone and phosphor-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.
  
  
  METHODS
  We performed a PubMed literature review using different MeSH Terms like "Nephrolithiasis", "Bone mineral density", "Urinary stones", "Calcium", Bone resorption" and "Bone formation", 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.
  
  
  RESULTS
  In different studies reviewed have 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 β-CrossLaps are determinant of nephrolithiasis and mineral density loss in these patients.
  
  
  CONCLUSIONS
  We recommend perform 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.
authors: Servicio de Urología, Hospital Universitario San Cecilio, Granada, España. Electronic address: arrabalp@ono.com.
authors: M Á
authors: MÁ
authors: Arrabal-Polo
authors: M
authors: M
authors: Sierra Girón-Prieto
authors: J
authors: J
authors: Orgaz-Molina
authors: A
authors: A
authors: Zuluaga-Gómez
authors: S
authors: S
authors: Arias-Santiago
authors: M
authors: M
authors: Arrabal-Martín
mesh_terms: D015415:Biomarkers; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000378:metabolism; D001862:Bone Resorption / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism*; D003404:Creatinine / Q000097:blood; D005215:Fasting / Q000097:blood; D006801:Humans; D006934:Hypercalcemia / Q000150:complications / Q000151:congenital / Q000378:metabolism; D007669:Kidney Calculi / Q000378:metabolism*; D008903:Minerals / Q000378:metabolism; D053040:Nephrolithiasis / Q000209:etiology / Q000378:metabolism*; D010012:Osteogenesis; D010024:Osteoporosis / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism
chemical_list: D015415:Biomarkers; D008903:Minerals; D010758:Phosphorus; D003404:Creatinine; D002118:Calcium