title: The importance of calciuria as lithogenic factors in patients with osteopenia/osteoporosis.
abstract: OBJECTIVE
  Recurrent kidney stones are associated with bone mineral density loss, altered bone remodeling markers, hypercalciuria and increased in fasting calcium/creatinine ratio. The objective was to determine biochemical alterations in urine in patients with osteopenia/osteoporosis without calcium kidney stones compared with patients with calcium kidney stones.
  
  
  METHODS
  This is a cross-sectional study including 142 patients who were divided in two groups: Group 1 (patients with recurrent calcium kidney stones) and Group 2 (patients with osteopenia/osteoporosis in the lumbar spine or hip). Analyses of bone mineral density, calcium-phosphorous and bone metabolism and lithogenic risk factors in fasting urine samples and 24-h urine samples were performed. Statistical analysis was carried out with SPSS 17.0. A p ≤ 0.05 was considered statistically significant.
  
  
  RESULTS
  Patients in Group 2 presented greater loss of bone mineral density and more elevated alkaline phosphatase, iPTH, phosphorous and β-crosslaps levels, as compared to patients in Group 1. However, Group 1 presented greater urine calcium, oxalate and uric acid and a higher proportion of hypocitraturia, hypercalciuria and hyperoxaluria, as compared to Group 2. Multivariate analysis revealed that advanced age and β-crosslaps levels are risk factors for bone mineral density loss, while low urinary calcium excretion was protective against bone demineralization.
  
  
  CONCLUSIONS
  Patients with osteopenia/osteoporosis without lithiasis present some urinary biochemical alterations. This would explain the lack of lithogenic activity, although low calcium excretion in 24-h urine samples is a protective factor against the loss of bone mineral density.
authors: UGC Urologia, Hospital Universitario San Cecilio, IBS Granada, Granada, Spain.
authors: Miguel
authors: M
authors: Arrabal-Martin
authors: Antonio
authors: A
authors: Poyatos-Andujar
authors: María del Carmen
authors: Mdel C
authors: Cano-García
authors: Miguel
authors: M
authors: Quesada-Charneco
authors: Felix
authors: F
authors: Abad-Menor
authors: María Sierra
authors: MS
authors: Girón Prieto
authors: Tomás
authors: T
authors: de Haro Muñoz
authors: Miguel Angel
authors: MA
authors: Arrabal-Polo
mesh_terms: D000328:Adult; D000367:Age Factors; D000469:Alkaline Phosphatase / Q000652:urine; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000652:urine; D002118:Calcium / Q000652:urine; D016022:Case-Control Studies; D003094:Collagen / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D053565:Hypercalciuria / Q000150:complications / Q000652:urine*; D007669:Kidney Calculi / Q000209:etiology* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000652:urine*; D019815:Oxalic Acid / Q000652:urine; D010281:Parathyroid Hormone / Q000652:urine; D010446:Peptide Fragments / Q000652:urine; D010758:Phosphorus / Q000652:urine; D012008:Recurrence; D014527:Uric Acid / Q000652:urine
chemical_list: D010281:Parathyroid Hormone; D010446:Peptide Fragments; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; D014527:Uric Acid; D010758:Phosphorus; D003094:Collagen; D019815:Oxalic Acid; D000469:Alkaline Phosphatase; D002118:Calcium
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