Skip to main content
Log in

Bone mineral content in calcium renal stone formers

  • Invited Review
  • Published:
Urological Research Aims and scope Submit manuscript

Abstract

Idiopathic renal calcium stone disease often presents with reduced bone mineral content. Investigations using non-invasive methods for the measurement of bone mineral content (single and dual-photon absorptiometry, dual-energy x-ray absorptiometry, quantitative computed tomodensitometry) show a slight decrease in skeletal mineral content of idiopathic renal stone formers (RSFs).The alterations in bone mineral content in RSFs have different explanations: prostaglandin-mediated bone resorption, subtle metabolic acidosis and 1–25 vitamin D disorders. Bone mineral content is worsened by insufficient dietary calcium leading to a negative calcium balance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Enisa Shevroja, Jean-Yves Reginster, … Nicholas C. Harvey

References

  1. Albright F, Aub JC, Bauer W (1934) Hyperparathyroidism: a common and polymorphic condition as illustrated by 17 proven cases from one clinic. JAMA 102: 1276

    Google Scholar 

  2. Alhava EM, Juuti M, Karjalainen P (1976) Bone mineral density in patients with urolithiasis. Scand J Urol Nephrol 10: 154

    PubMed  Google Scholar 

  3. Anderson J, Lee HA, Tomlinson RWS (1976) Some metabolic aspects of idiopathic hypercalciuria. Nephron 4: 129

    Google Scholar 

  4. Barkin J, Wilson DR, Manuel MA, Bayley A, Murray T, Harrison J (1985) Bone mineral content in idiopathic calcium nephrolithiasis. Miner Electrol Metab 11: 19

    Google Scholar 

  5. Bataille P, Bouillon R, Fournier A, Renaud H, Gueris J, Idrissi A (1987) Increased plasma concentrations of total and free 1,25-(OH)2D3 in calcium stone formers with idiopathic hypercalciuria. Contr Nephrol 58: 137

    Google Scholar 

  6. Bataille P, Achard JM, Fournier A, Boudail B, Westeel PF, Esper N, Bergot C, Jans I, Lalau JD, Petit J, Henon G, Laval A, Jeantet MA, Bouillon R, Sebert JL (1991) Diet, vitamin D and vertebral mineral density in hypercalciuric calcium stone formers. Kidney Int 39: 1193

    PubMed  Google Scholar 

  7. Bataille P, Marie A, Ghazali A, Cohen Solal ME, Steiniche T, Brazier M, Gueris J, Sebert JL, Fournier A (1996) Histological and biochemical study of bone turnover in calcium stone formers (CSF) with fasting hypercalciuria and osteopenia. In: Pak CYC, Resnick MI, Preminger GM (ed) Urolithiasis 1996. Millet, Dallas, p 1

  8. Bordier P, Ryckewart A, Gueris J (1977) On the pathogenesis of so-called hypercalciuria. Am J Med 63: 398

    Article  PubMed  Google Scholar 

  9. Borghi L, Meschi T, Guerra A, Maninetti L, Pedrazzoni M, Marcato A, Vescovi P, Novarini A (1991) Vertebral mineral content in diet-dependent and diet-independent hypercalciuria. J Urol 146: 1334

    PubMed  Google Scholar 

  10. Broadus AE, Horst RL, Lang R, Littledike ET, Rasmussen H (1980)The importance of circulating 1,25(OH)2D in the pathogenesis of hypercalciuria and renal stone formation in primary hyperparathyroidism. N Engl J Med 302: 421

    Google Scholar 

  11. Broadus AE, Insogna KL, Lang R, Ellison AF, Dreyer BE (1984) Evidence for disordered control of 1,25-dihydroxyvitamin D production in absorptive hypercalciuria. N Engl J Med 311: 73

    PubMed  Google Scholar 

  12. Buck AC, Lote CJ, Sampson WF (1983) The influence of renal prostaglandins on urinary calcium excretion in idiopathic urolithiasis. J Urol 129: 421

    PubMed  Google Scholar 

  13. Coe FL, Kavalach AG (1974) Hypercalciuria and hyperuricosuria in patients with calcium nephrolithiasis. N Engl J Med 291: 1344

    PubMed  Google Scholar 

  14. Coe FL, Favus MJ, Crockett T, Strauss AL, Parks JH, Porat A, Gantt CL, Sherwood LM (1982) Effects of low-calcium diet on urine calcium excretion, parathyroid function and serum 1,25(OH)2D3 levels in patients with idiopathic hypercalciuria and in normal subjects. Am J Med 72: 25

    Article  PubMed  Google Scholar 

  15. Cormier C (1995) Markers of bone metabolism. Curr Opin Rheumatol 7: 243

    PubMed  Google Scholar 

  16. Dalen N, Hjern B (1974) Bone mineral content in patients with primary hyperparathyroidism without radiological evidences of skeletal changes. Acta Endocrinol 75: 297

    PubMed  Google Scholar 

  17. Dent CE, Hartland BV, Hicks J, Sykes ED (1961) Calcium intake with primary hyperparathyroidism. Lancet 2: 336

    Article  PubMed  Google Scholar 

  18. Diaz Perez de Madrid J, Munoz Torres M, Garcia de Vinuesa MJ, Mijan JL, Escobar Jimenez F, Zuluaga A (1989) Parathormone, cyclic AMP, 1,25 dihydroxyvitamin D and osteocalcin in hypercalciuric renal lithiasis. Arch Esp Urol 42: 129

    PubMed  Google Scholar 

  19. Filipponi P, Mannarelli C, Pacifici R, Grossi E, Moretti I, Tini S, Carloni C, Blass A, Morucci P, Hruska KA, Avioli LV (1988) Evidence for a prostaglandin-mediated bone resorptive mechanism in subjects with fasting hypercalciuria. Calcif Tissue Int 43: 61

    PubMed  Google Scholar 

  20. Forland M, Strandjord NM, Paloyan E, Cox A (1968) Bone density studies in primary hyperparathyroidism. Arch Intern Med 122: 236

    Article  PubMed  Google Scholar 

  21. Frost HM (1983) The skeletal intermediary organization: a review. Metab Bone Dis Rel Res 4: 281

    Google Scholar 

  22. Fuss M, Gillet C, Simom J, Vandewalle J-C, Schoutens A, Bergmann P (1983) Bone mineral content in idiopathic renal stone disease and in primary hyperparathyroidism. Eur Urol 9: 32

    PubMed  Google Scholar 

  23. Fuss M, Pepersack T, Bergman P, Hurard T, Simon J, Corvilain J (1990) Low calcium diet in idiopathic urolithiasis: a risk factor for osteopenia as great as in primary hyperparathyroidism. Br J Urol 65: 560

    PubMed  Google Scholar 

  24. Fuss M, Pepersack T, Van Geel J, Corvilain J, Vandewalle JC, Bergmann P, Simon J (1990) Involvement of low-calcium diet in the reduced bone mineral content of idiopathic renal stone formers. Calcif Tissue Int 46: 9

    PubMed  Google Scholar 

  25. Fuss M, Pepersack T, Corvilain J, Bergmann P, Simon J, Body JJ (1991) Calcitonin secretion in idiopathic renal stone formers. J Bone Miner Res 6: 35

    PubMed  Google Scholar 

  26. Ghazali A, Fuentes V, Deisaint C, Westeel A, Brazier M, Prin L, Fournier A (1997) Low bone mineral density and peripheral monocyte activation profile in calcium stone formers with idiopathic hypercalciuria. J Clin Endocrinol Metab 82: 32

    Article  PubMed  Google Scholar 

  27. Goldfarb S (1988) Dietary factors in the pathogenesis and prophylaxis of nephrolithiasis. Kidney Int 34: 544

    PubMed  Google Scholar 

  28. Hess B, Casez J-P, Takkinen R, Ackermann D, Jaeger P (1993) Relative hypoparathyroidism and calcitriol up-regulation in hypercalciuric calcium renal stone formers. Impact of nutrition. Am J Nephrol 13: 18

    PubMed  Google Scholar 

  29. Hisazumi H, Katsumi T (1970) A study of the mineral contents of the bone by x-rays in patients with urolithiasis. Jpn J Urol 61: 266

    Google Scholar 

  30. Hosgkin DJ, Chamberlain MJ, Fremlin JH (1972) Changes in total body calcium content in primary hyperparathyroidism. Clin Sci 43: 627

    PubMed  Google Scholar 

  31. Jaeger P, Lippuner K, Casez J-P, Hess B, Ackermann D, Hug C (1994) Low bone mass in idiopathic renal stone formers: magnitude and significance. J Bone Miner Res 9: 1525

    PubMed  Google Scholar 

  32. Jungers P, Houillier P, Liote F, De Groote D, Labrunie M, Daudon M, Descamps-Latscha B (1996) Imbalance between monocyte-derived cytokines and their specific inhibitors in idiopathic hypercalciuria. In: Pak CYC, Resnick MI, Preminger GM (eds) Urolithiasis 1996.. Millet, Dallas, p 68

  33. Kanis JA, Melton LJIII, Christiansen C, Johnson CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9: 1137

    PubMed  Google Scholar 

  34. Kaplan RA, Haussler MR, Deftos LJ, Bone H, Pak CYC (1977) The role of 1,25(OH)2D in the mediation of intestinal hyperabsorption of calcium in primary hyperparathyroidism and absorptive hypercalciuria. J Clin Invest 59: 756

    PubMed  Google Scholar 

  35. Katayama Y, Umekawa T, Ishikawa Y, Kodama M, Takada M, Katoh Y, Kataoka K, Kohri K, Iguchi M, Kurita T (1990) Calcium urolithiasis and bone change. Nippon Hinyokika Gakkai Zasshi 81: 89

    PubMed  Google Scholar 

  36. Kuczera M, Wiecek A, Kokot F (1993) Estimation of selected markers of bone metabolism in patients with nephrolithiasis. Pol Arch Med Wewn 89:385

    PubMed  Google Scholar 

  37. Lauderdale DS, Thisted RA, Wen M, Favus MJ (2001) Bone mineral density and fracture among prevalent kidney stone cases in the Third National Health and Nutrition Examination Survey. J Bone Miner Res 16: 1893

    PubMed  Google Scholar 

  38. Lawoyin S, Sismilich S, Browne B, Pak CYC (1979) Bone mineral content in patients with calcium urolithiasis. Metabolism 28: 1250

    Article  PubMed  Google Scholar 

  39. Lemann JJr, Litzow JR, Lennon EJ (1966) The effects of chronic acid loads in normal man: further evidence for the participation of bone mineral in the defense against chronic metabolic acidosis. J Clin Invest 45: 1608

    PubMed  Google Scholar 

  40. Liberman UA, Sperling O, Atsmon A (1969) Metabolic and calcium kinetic studies in idiopathic hypercalciuria. J Clin Invest 47: 2580

    Google Scholar 

  41. Lindergard B, Colleen S, Mansson W, Rademark C, Rogland B (1983) Calcium loading test and bone disease in patients with urolithiasis. Proc EDTA 20: 460

    Google Scholar 

  42. Maierhofer WF, Gray RW, Cheung HS, Lemann J (1984) Dietary calcium and serum 1,25(OH)2-vitamin D concentrations as determinants of calcium balance in healthy men. Kidney Int 26: 752

    PubMed  Google Scholar 

  43. Mallette LE, Bilezikian JP, Heath H, Auerbach GD (1974) Primary hyperparathyroidism: clinical and biochemical features. Medicine 53: 127

    PubMed  Google Scholar 

  44. Malluche HH, Tschope W, Ritz E, Meyer-Sabellek W, Massry SG (1980) Abnormal bone histology in idiopathic hypercalciuria. J Clin Endocrinol Metab 50: 654

    PubMed  Google Scholar 

  45. Malvasi L, Sartori I, Giannini S, Al Awady M, Musaio F, Varotto S, D’Angelo A (1988) Mineral metabolism and bone mineral content in calcium nephrolithiasis with and without hyperparathyroidism. Urol Res 16: 190

    Google Scholar 

  46. Martin P, Bergmann P, Gillet C (1986) Partially reversible osteopenia after surgery for primary hyperparathyroidism. Arch Intern Med 146: 689

    Article  PubMed  Google Scholar 

  47. Maruyama Y, Hirata N, Yamada H, Sasaki K, Motomiya Y, Hirao Y, Okajima E (1993) A study on markers of bone metabolism in patients with non hypercalciuric calcium stone: measurement of gamma-carboxyglutamic acid and hydroxyproline. Nippon Hinyokika Gakkai Zasshi 84: 541

    PubMed  Google Scholar 

  48. Melton LJ III, Crowson CS, Khosla S, Wolson DM, O’Fallon WM (1998) Fracture risk among patients with urolithiasis: a population-based cohort study. Kidney Int 53: 459

    Article  PubMed  Google Scholar 

  49. Messa P, Mioni G, Montanaro D, Adorati M, Antonucci F, Favazza A, Messa A, Enzmann G, Paganin L, Nardini R (1987) About a primitive osseous origin of the so-called “renal hypercalciuria”. Contr Nephrol 58: 106

    Google Scholar 

  50. Minisola S, Rosso R, Romagnoli E, Pacitti MT, Scarnecchia L, Carnevale V, Mazzuoli G (1993) Trabecular bone mineral density in primary hyperparathyroidism: relationship to clinical presentation and biomarkers of skeletal turnover. Bone Miner 20: 113

    PubMed  Google Scholar 

  51. Muldowney FP, Freaney R, Moloney MF (1982) Importance of dietary sodium in the hypercalciuria syndrome. Kidney Int 22: 292

    PubMed  Google Scholar 

  52. Netelenbos JC, Jongen MJM, Van der Vijgh WJF, Lips P, Van Ginkel FC (1985) Vitamin D status in urinary calcium stone formation. Arch Intern Med 145: 681

    Article  PubMed  Google Scholar 

  53. Nordin BEC, Peacock M, Wilkinson R (1972) Hypercalciuria and calcium stone disease. Clin Endocrinol Metab J 1: 169

    Google Scholar 

  54. Osther PJ, Bollerslev J, Hansen AB, Engel K, Kildeberg (1993) Pathophysiology of incomplete renal tubular acidosis in recurrent renal stone formers: evidence of disturbed calcium, bone and citrate metabolism. Urol Res 21: 169

    Article  PubMed  Google Scholar 

  55. Pacifici R, Rothstein M, Rifas L, Lau KHW, Baylink DG, Avioli LV, Hruska K (1990) Increased monocyte interleukin-I activity and decreased vertebral bone density in patients with fasting hypercalciuria. J Clin Endocrinol Metab 71: 138

    PubMed  Google Scholar 

  56. Pak CYC, Kaplan R, Bone H, Towsend J, Waters O (1975) A simple test for the diagnosis of absorptive, resorptive and renal hypercalciuria. N Engl J Med 292: 497

    PubMed  Google Scholar 

  57. Pak CYC, Nicar MJ, Peterson R, Zerwekh JE, Snyder W (1981) Lack of unique pathophysiologic background for nephrolithiasis in primary hyperparathyroidism. J Clin Endocrinol Metab 53: 536

    PubMed  Google Scholar 

  58. Peacock M (1975) Renal stone disease in primary hyperparathyroidism and their relationship to the action of PTH on calcium absorption. In: Talmadge R (ed) Calcium regulating hormones. Excerpta Medica, Amsterdam, p 78

  59. Pietschmann F, Breslau NA, Pak CYC (1992) Reduced vertebral bone density in hypercalciuric nephrolithiasis. J Bone Miner Res 7: 1383

    PubMed  Google Scholar 

  60. Pines KL, Mudge GH (1951) Renal tubular acidosis with osteomalacia. Am J Med 11: 302

    Article  PubMed  Google Scholar 

  61. Rao PN, Blacklock NJ (1983) A non-steroidal anti-inflammatory drug (flubiprofen) to control idiopathic hypercalciuria resistant to dietary manipulation. Br J Urol 55: 599

    PubMed  Google Scholar 

  62. Rao DS, Wilson RJ, Kleerkoper M et al. (1988) Lack of biochemical progression of continuation of accelerated bone loss in mild asymptomatic primary hyperparathyroidism: evidence for a biphasic course. J Clin Endocrinol Metab 67: 1294

    PubMed  Google Scholar 

  63. Rico H, Paramo P, Perez del Molino J, Nacarino L, Yague M (1988) Osteocalcin, parathormone and hypercalciuria. Eur Urol 15: 239

    PubMed  Google Scholar 

  64. Riggs BL, Wahner HW, Dunn WL, Mazess PB, Offord KP, Melton L (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with ageing. J Clin Invest 67: 328

    PubMed  Google Scholar 

  65. Shen FH, Baylink DJ, Nielsen RL, Sherrard DJ, Ivey JL, Haussler MR (1977) Increased serum 1,25-dihydroxy vitamin D in idiopathic hypercalciuria. J Lab Clin Med 6: 955

    Google Scholar 

  66. Silverberg SJ, Shane E, Jacobs TP, Siris ES, Gartenberg F, Seldin D, Clemens TL, Bliezikian JP (1990) Nephrolithiasis and bone involvement in primary hyperparathyroidism. Am J Med 89: 327

    Article  PubMed  Google Scholar 

  67. Sowers MR, Jannausch M, Wood C, Pope SK, Lachance LL, Peterson (1998) Prevalence of renal stones in a population-based study of dietary calcium, oxalate, and medication exposures. Am J Epidemiol 147: 914

    PubMed  Google Scholar 

  68. Sperling O, Weinberger A, Oliver I, Liberman UA, De Vries A (1974) Hypouricemia, hypercalciuria and decreased bone density. A hereditary syndrome. Ann Intern Med 80: 482

    PubMed  Google Scholar 

  69. Steiniche T, Mosekilde L, Christensen MS, Melsen F (1989) A histomorphometric determination of iliac bone remodeling in patients with recurrent renal stone formation and idiopathic hypercalciuria. APMIS 4: 309

    Google Scholar 

  70. Sutton RAL, Walker VR (1986) Bone resorption and hypercalciuria in calcium stone-formers. Metabolism 35: 485

    Article  PubMed  Google Scholar 

  71. Takeda M, Katayama Y, Go H, Wakatsuki S, Kawasaki T, Sato S, Odano I (1991) Bone mineral densitometry by dual photon absorptiometry in patients with urolithiasis: on the possibility of the differential diagnosis of idiopathic hypercalciuria. Nippon Hinoyokika Gakkai Zasshi 82: 1954

    Google Scholar 

  72. Taylor AK, Lenken SA, Libanati C, Baylink DJ (1994) Biochemical markers of bone turnover for the clinical assessment of bone metabolism. Rheum Dis Clin North Am 20: 589

    PubMed  Google Scholar 

  73. Thomsen K, Gotfredsen A, Christiansen C (1986) Is postmenopausal bone loss an age-related phenomenon? Calcif Tissue Int 39: 123

    PubMed  Google Scholar 

  74. Tieder M, Modai D, Shaked U, Samuel R, Arie R, Halabe A, Maor J, Weissgarten J, Averbukh A, Cohen N, Edelstein S, Liberman U (1987) Idiopathic hypercalciuria and hereditary hypophosphatemic rickets. N Engl J Med 316: 125

    PubMed  Google Scholar 

  75. Trinchieri A, Nespoli R, Ostini F, Rovera F, Zanetti G, Pisani E (1998) A study of dietary calcium and other nutrients in idiopathic renal calcium stone formers with low bone mineral content. J Urol 159: 654

    Article  PubMed  Google Scholar 

  76. Trinchieri A, Zanetti G, Currò A, Lizzano R (2001) Effect of potential renal acid load of foods on calcium metabolism of renal calcium stone formers. Eur Urol 39 [Suppl 2]: 33

  77. Velentzas C, Oreopoulos DG, Meema S, Meema HE, Nutsuga T, Alison E, Katirtzoglou A, Crassweller P (1981) Dietary calcium restriction may be good for patients’ stones but not for their bones. In: Smith LH, Robertson WG, Finlayson B (eds) Urolithiasis clinical and basic research. Plenum Press, New York. p 847

  78. Weisenberg JR, Alonzo E, Bellorinfont E, Blasini AM, Rodriguez MA, Pazmartinez V, Martinis R (1996) Possible role of cytokines on the bone mineral loss in idiopathic hypercalciuria. Kidney Int 49: 244

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Trinchieri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Trinchieri, A. Bone mineral content in calcium renal stone formers. Urol Res 33, 247–253 (2005). https://doi.org/10.1007/s00240-005-0498-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-005-0498-y

Keywords

Navigation