title: Urine Calcium and Bone Mineral Density in Calcium Stone-Forming Patients Treated with Alendronate and Hydrochlorothiazide.
abstract: BACKGROUND
  The objective was to evaluate the effect of hydrochlorothiazide and alendronate on urine calcium and bone mineral density in calcium stone-forming patients.
  
  
  METHODS
  A prospective, non-randomized, non-observational comparative study was performed; this study included 111 patients with recurrent calcium stones, divided into 3 groups according to the treatment received. Group 1: 36 patients were treated with alendronate, 70 mg/week; Group 2: 34 patients were treated with alendronate, 70 mg/week + hydrochlorothiazide, 50 mg/day; Group 3: 41 patients were treated with hydrochlorothiazide, 50 mg/day. All patients received recommendations on diet and fluid intake. Other variables of bone mineral density were studied and analyzed, including bone remodeling markers and urinary calcium before and after 2 years of treatment. The statistical analysis was performed using the SPSS 17.0 program, with a statistical significance of p < 0.05.
  
  
  RESULTS
  After 2 years of treatment, a significant difference was observed in the β-crosslaps and a bone mineral density improvement in Group 1, along with a decrease in urinary calcium. In Group 3, a statistically significant difference was found in urinary calcium and fasting calcium/creatinine ratio, as well as an improvement in bone mineral density after 2 years of medical treatment. In Group 2 patients treated with the combination, there was an improvement in bone mineral density and a decrease in the β-crosslaps marker similar to patients in Group 1, and a decrease in urinary calcium similar to those in Group 3.
  
  
  CONCLUSIONS
  Combined alendronate + hydrochlorothiazide treatment offers the best results along with the improvement in bone mineral density and decrease in urine calcium in patients with recurrent calcium stones.
authors.affiliation: Urology Department, Poniente Hospital, Almeria, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Arrabal-Martín
authors.forename: Samuel
authors.initials: S
authors.lastname: González-Torres
authors.forename: María Del Carmen
authors.initials: MD
authors.lastname: Cano-García
authors.forename: Tomás
authors.initials: T
authors.lastname: De Haro-Muñoz
authors.forename: Félix
authors.initials: F
authors.lastname: Abad-Menor
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Arrabal-Polo
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Cózar-Olmo
mesh_terms: D019386:Alendronate / Q000494:pharmacology* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002118:Calcium / Q000737:chemistry / Q000652:urine*; D004232:Diuretics / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000494:pharmacology* / Q000627:therapeutic use; D007669:Kidney Calculi / Q000188:drug therapy* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors
chemical_list: D050071:Bone Density Conservation Agents; D004232:Diuretics; D006852:Hydrochlorothiazide; D002118:Calcium; D019386:Alendronate