Lower Vertebral Mineral Density in Calcium Stone Formers with Normocalciuria and Idiopathic Hypercalciuria: Evidence for Primary Bone Resorption in Idiopathic Hypercalciuria
Calcium lithiasis is a multifactorial disease, hypercalciuria remaining the most common risk factor. The pathogenesis of idiopathic hypercalciuria (IH) remains controversial, especially regarding whether or not hypercalciuria is secondary to a primary intestinal or a renal tubular defect. Although primary intestinal hyperabsorption of calcium is considered to be the most prevalent mechanism by Pak et al. (1), calcium balances have been found negative in two-thirds of the IH patients, implying a loss of their bone mineral (2). Moreover, a low calcium diet is still frequently advised for these patients in spite of its doubtful efficacy and potential hazard because of the possible contribution of bone to hypercalciuria. For these reasons, this study was performed with the following aims: a) to assess the vertebral mineral density (VMD) of patients with idiopathic calcium nephrolithiasis classified according to their calcium excretion; and b) to relate their VMD to other parameters of their calcium and bone metabolism in order to have some insight into the pathogenesis of idiopathic hypercalciuria.
KeywordsFree Diet Calcium Stone Idiopathic Hypercalciuric Regard Body Weight Renal Tubular Defect
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