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Review
. 2008 Mar;28(2):133-42.
doi: 10.1016/j.semnephrol.2008.01.006.

Bone disease and idiopathic hypercalciuria

Joseph E Zerwekh  1
Affiliations
Review

Bone disease and idiopathic hypercalciuria

Joseph E Zerwekh. Semin Nephrol. 2008 Mar.

Abstract

Observational and epidemiologic studies alike have shown that idiopathic hypercalciuric (IH) stone-forming patients typically show bone mineral density scores that are significantly lower than those observed for age- and sex-matched normal subjects or those for nonhypercalciuric stone-forming patients. Most of these studies have relied on changes in bone mineral density and have not explored the mechanism(s) involved. There have been a small number of studies that have relied on dynamic bone histomorphometry to ascertain the nature of the bone defect in IH patients. When performed, these studies clearly have shown increased bone resorption and high bone turnover in patients with fasting hypercalciuria whereas suppressed bone formation indices are the most consistent finding in patients with the absorptive variant of IH. The causes of this apparent difference in bone remodeling between the 2 variants of IH still is uncertain. Available evidence suggests that potential mechanisms may be dependent in large part to genetic, metabolic, and nutritional causes of hypercalciuria and bone loss in patients with IH.

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Figures

Figure 1
Figure 1
The association between customary dietary calcium intake and age-adjusted femoral neck BMD for men with and without a history of kidney stones. Customary dietary calcium intake was determined from self-reported habitual milk consumption. Age-adjusted BMD values are relative to men with no kidney stone history and no habitual milk consumption. Reproduced from J Bone Min Res 16:1893–1898, 2001; with permission of the American Society for Bone and Mineral Research.
Figure 2
Figure 2
Microphotographs of cancellous bone from rat femur. (A) Trabecular bone from a rat that had been on a low casein diet for 2 months demonstrating osteoid and osteoblasts (arrow) and normal bone formation. (B) Trabecular bone from a rat that had been on a high casein diet demonstrating a marked increase in the number of active osteoclasts and extent of eroded surface (arrows). Final magnification 160X.
See this image and copyright information in PMC

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