Document Detail


Prevention of stone formation and bone loss in absorptive hypercalciuria by combined dietary and pharmacological interventions.
MedLine Citation:
PMID:  12544288     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We determined whether dietary restriction of calcium and oxalate, combined with thiazide and potassium citrate treatment, would prevent stone formation and avert bone loss in 18 men and 10 women with type I absorptive hypercalciuria. MATERIALS AND METHODS: Patients were treated with thiazide (20) or indapamide (8) and potassium citrate (average dose 35 mEq. daily) for 1 to 11 years (mean 3.7) while maintained on low calcium oxalate diet. Serum and urinary chemistry studies and bone mineral density were measured at baseline and at the end of treatment. New stones formed were quantitated during 3 years before and during treatment. RESULTS: During treatment urinary calcium significantly decreased (346 +/- 85 to 248 +/- 79 mg. daily, p <0.001) but urinary oxalate did not change. Urinary pH and citrate significantly increased, and urinary saturation of calcium oxalate significantly decreased by 46%. Stone formation rate decreased significantly from 2.94 to 0.05 per year (p <0.001). L2-L4 bone mineral density increased significantly by 5.7% compared to normal peak value, and by 7.1% compared with normal age and gender matched value. Femoral neck bone mineral density also increased significantly. CONCLUSIONS: Dietary restriction of calcium and oxalate, combined with thiazide and potassium citrate, satisfactorily controlled hypercalciuria, prevented the secondary increase in urinary oxalate, reduced urinary saturation of calcium oxalate, virtually eliminated recurrent stone formation, and increased bone density of the spine and femoral neck. Thus, this dietary pharmacological program controlled stone formation as well as bone loss that often accompany type 1 absorptive hypercalciuria.
Authors:
Charles Y Pak; Howard J Heller; Margaret S Pearle; Clarita V Odvina; John R Poindexter; Roy D Peterson
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of urology     Volume:  169     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-01-24     Completed Date:  2003-02-25     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-9     Citation Subset:  AIM; IM; S    
Affiliation:
Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390-8885, USA.
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MeSH Terms
Descriptor/Qualifier:
Absorption
Adult
Benzothiadiazines*
Bone Resorption / prevention & control*
Calcium / urine*
Calcium, Dietary / administration & dosage*
Combined Modality Therapy
Diet*
Diuretics
Female
Humans
Kidney Calculi / prevention & control*
Male
Middle Aged
Oxalates / administration & dosage*
Potassium Citrate / therapeutic use*
Sodium Chloride Symporter Inhibitors / therapeutic use*
Grant Support
ID/Acronym/Agency:
M01-RR00633/RR/NCRR NIH HHS; P01-DK20543/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Benzothiadiazines; 0/Calcium, Dietary; 0/Diuretics; 0/Oxalates; 0/Sodium Chloride Symporter Inhibitors; 6100-05-6/Potassium Citrate; 7440-70-2/Calcium
Comments/Corrections
Comment In:
J Urol. 2003 Feb;169(2):478-9   [PMID:  12544291 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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