title: Pediatric nephrolithiasis and the link to bone metabolism.
abstract: OBJECTIVE
  To review the recent publications describing the link between pediatric nephrolithiasis and bone metabolism.
  
  
  RESULTS
  Nephrolithiasis incidence is increasing in children and is associated with low bone mineral density (BMD). Affected children are conceptually at risk for fractures and osteoporosis. In addition to abnormal calcium metabolism, inflammation, genetic makeup and dietary habits are being recognized as important factors in the pathophysiology of nephrolithiasis and low bone density. Findings from retrospective reviews suggest that low BMD in children may be improved with citrate or thiazide treatment.
  
  
  CONCLUSIONS
  The healthcare burden from low BMD with subsequent osteoporosis and fracture risk is immense with potential far-reaching effects in patient quality of life and healthcare expense. Bone mass is acquired in the pediatric age range, thus it is important to identify and treat at-risk children. Retrospective reviews in pediatric patients indicate that citrate or thiazide diuretic treatment may improve BMD. We now understand that a relationship exists between nephrolithiasis and low BMD. To improve healthcare for our current patients as well as protect their future health it is important to identify low BMD and initiate strategies to improve BMD in 'at-risk' children.
authors.affiliation: aNationwide Children's Hospital, The Ohio State University, Department of Pediatrics, Division of Nephrology bThe Research Institute at Nationwide Children's Hospital, Center for Clinical and Translational Medicine cPediatric Nephrology Fellowship, Nationwide Children's Hospital, Ohio, USA.
authors.forename: Andrew Lawrence
authors.initials: AL
authors.lastname: Schwaderer
authors.forename: Kirsten
authors.initials: K
authors.lastname: Kusumi
authors.forename: Rose Mary
authors.initials: RM
authors.lastname: Ayoob
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001842:Bone and Bones / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D019343:Citric Acid / Q000627:therapeutic use; D005247:Feeding Behavior; D050723:Fractures, Bone / Q000188:drug therapy / Q000473:pathology* / Q000517:prevention & control; D020022:Genetic Predisposition to Disease; D006801:Humans; D007249:Inflammation / Q000150:complications; D053040:Nephrolithiasis / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D010024:Osteoporosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D012307:Risk Factors; D049971:Thiazides / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D049971:Thiazides; D019343:Citric Acid