Bone Disease and Idiopathic Hypercalciuria
Section snippets
Clinical Studies
Several of the earliest studies that assessed BMD in patients with idiopathic hypercalciuria (IH) suggested that bone mass or bone mineral content (BMC) was lower than that observed for age- and sex-matched normal subjects. However, most of these studies did not clearly define the underlying mechanism for the hypercalciuria or consistently present urinary calcium data. For example, Alhava et al1 used single-photon absorptiometry (SPA) to quantitate the BMC of the radius in an unselected
What is the Nature of the Defect in Bone Remodeling in Idiopathic Hypercalciuric Patients?
There have been relatively few studies directed at examining bone remodeling dynamics in IH patients. This is probably the result of the need for controlled diets before evaluation, the invasive nature of some procedures such as bone biopsy, and lack of willing patients because of relatively mild asymptomatic bone disease. Two studies have used only biochemical markers of bone turnover. In the study by Jaeger et al,9 urinary hydroxyproline as well as the collagen cross-links, pyridinoline and
What Mechanisms are Responsible for Bone Loss in IH?
From the foregoing discussion, it is apparent that 2 general types of bone remodeling defects are present in patients with IH and are dependent on the nature of the hypercalciuria. For those with a clear picture of renal hypercalciuria resulting from either renal calcium leak or from increased filter load of calcium, the remodeling defect is consistent with one of increased bone turnover, whereas in those with the absorptive form of hypercalciuria the defect appears to be more consistent with
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Supported in part by National Institutes of Health grant P01-DK20543.