| Prevention of stone formation and bone loss in absorptive hypercalciuria by combined dietary and pharmacological interventions. | |
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MedLine Citation:
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PMID: 12544288 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Charles Y Pak; Howard J Heller; Margaret S Pearle; Clarita V Odvina; John R Poindexter; Roy D Peterson |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The Journal of urology Volume: 169 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-01-24 Completed Date: 2003-02-25 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 465-9 Citation Subset: AIM; IM; S |
Affiliation:
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Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390-8885, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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M01-RR00633/RR/NCRR NIH HHS; P01-DK20543/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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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:
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J Urol. 2003 Feb;169(2):478-9
[PMID:
12544291
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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