title: Metabolic bone loss after urinary diversion in children.
abstract: OBJECTIVE
  It has been widely known for some time that bone loss can be seen in certain subpopulations of children undergoing urinary diversion and/or enterocystoplasty. This review will hopefully look at the recent evidence in the field and help understand the multifactorial cause of bone loss in this group of individuals, as well as look at evidence for this phenomenon in growth retardation in certain groups of these individuals.
  
  
  RESULTS
  Most of the recent publications indicate that in normal individuals, decreased bone mineralization does not appear to affect final growth or adult height. It would appear that over time, demineralization allows compensation of the acidosis. However, it should be noted that it does lead to an increase in both osteoclastic and osteoblastic activity.
  
  
  CONCLUSIONS
  It is very likely that enterocystoplasty in childhood can lead to significant metabolic acidosis and that compensation with bone buffering does take place. It would appear that the bone demineralization secondary to increased osteoblastic and osteoclastic activity is the price paid for metabolic compensation and continued normal and near normal linear growth.
authors.affiliation: aColumbia University College of Physicians & Surgeons' New York, New York bThe University of Vermont, Burlington, Vermont cRutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Terry W
authors.initials: TW
authors.lastname: Hensle
authors.forename: Gerald
authors.initials: G
authors.lastname: Mingin
authors.forename: Mina
authors.initials: M
authors.lastname: Fam
mesh_terms: D000138:Acidosis / Q000209:etiology*; D001851:Bone Diseases, Metabolic / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007421:Intestine, Small / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects*; D016476:Urinary Reservoirs, Continent