Endocrine Abstracts

Much attention is attracted increased risk of fractures in patients with urolithiasis. Study the possible relationship of pathophysiological mechanisms of osteoporosis/osteopenia and nephrolithiasis.

Objective: To assess the state of bone metabolism, vitamin D level in patients with urolithiasis compared with healthy individuals.

Methods: Were examined 58 patients with nephrolithiasis (36 women, and 22 men) and 20 healthy individuals (17 women, and three men). Exclusion criteria: primary hyperparathyroidism and other endocrine pathology, chronic renal failure, bisphosphonates and/or calcium and vitamin D in history. Group matched for age (50±11.4 and 51±12.7 years respectively), the number of women in menopause, renal function, carbohydrate and purine metabolism, BMI. All patients underwent a study of markers of bone turnover (b-cross laps (CTX), osteocalcin (OC)), 25 OH vitamin D (from autumn to early spring), PTH, calcium in the blood and urine daily.

Results: According to the results of significant differences in the level of PTH, 25 OH vitamin D, CTX and OC between patients with nephrolithiasis and the control group was not obtained. However, in patients with nephrolithiasis has a tendency to a higher frequency of vitamin D insufficiency in 60.3 and 36.2% in the deficit than in the control group – hypovitaminosis D in 50%, 25% deficit (P_X2 <0.05). Mean level of calcium in the blood was comparable in groups, reducing urinary calcium in both groups 15%, hypercalciuria noted only in patients with nephrolithiasis in 12%. In 30% of patients with urolithiasis recorded a slight increase in PTH levels, which was regarded as secondary hyperparathyroidism against the background deficiency of vitamin D. in the control group revealed no increase in PTH levels. Patients with nephrolithiasis 12% of cases, in contrast to the control group, marked decrease of the average OK to 8.3±2.7 ng/ml at a rate of 11.0–43.0. Increasing CTX did not differ between the groups was observed in of nephrolithiasis and 10% in the control.

Conclusions: There were no differences in terms of calcium-phosphorus metabolism and bone metabolism between patients with nephrilithiasis and healthy individuals. Further studies with the definition of the BMD in comparison with the general population.