1
|
Jia S, Liao J, Wang Y, Zheng W, Jin J, Xu W, Zheng Q. Prevalence of osteoporosis in patients with nephrolithiasis and vice versa: a cumulative analysis. Front Endocrinol (Lausanne) 2023; 14:1180183. [PMID: 37469974 PMCID: PMC10352837 DOI: 10.3389/fendo.2023.1180183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/24/2023] [Indexed: 07/21/2023] Open
Abstract
Purpose Nephrolithiasis is thought to be a risk factor for osteoporosis, but data assessing if osteoporosis predisposes to the risk of nephrolithiasis are lacking. The present study aims to investigate whether patients with nephrolithiasis have a prominently higher prevalence of osteoporosis than the controls and vice versa via a cumulative analysis. Methods Four databases were used to detect the eligible studies. We calculated the relative risk (RR) with a 95% confidence interval (CI) to assess the combined effect. The methodologies for conducting this study followed the PRISMA guidelines and were registered in the PROSPERO (ID: CRD42023395875). Results Nine case-control or cohort studies with a total of 454,464 participants were finally included. Combined results indicated that there was a significantly higher prevalence of osteoporosis in patients with nephrolithiasis as compared to the general population without nephrolithiasis (overall RR from six studies= 1.204, 95%CI: 1.133 to 1.28, P< 0.001; heterogeneity: I2 = 34.8%, P= 0.162). Conversely, osteoporosis was significantly correlated to an increased risk of nephrolithiasis as compared to the controls without osteoporosis (overall RR from four studies= 1.505, 95%CI: 1.309 to 1.731, P< 0.001; I2 = 89.8%, P< 0.001). Sensitivity analysis on the two categories validated the above findings. No significant publication bias was identified in this study. Conclusions The present study highlighted a significantly high prevalence of osteoporosis in patients with nephrolithiasis and vice versa. This reciprocal association reminded the clinicians to conduct a regular follow-up assessment when managing patients with nephrolithiasis or osteoporosis, especially for the elderly. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier CRD42023395875.
Collapse
Affiliation(s)
- Shunjie Jia
- Department of Orthopedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Jian Liao
- Department of Nephrology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang, China
| | - Yucheng Wang
- Department of Orthopedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Wenbiao Zheng
- Department of Orthopedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Jinghua Jin
- Department of Orthopedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Weifang Xu
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Qi Zheng
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| |
Collapse
|
2
|
Rendina D, De Filippo G, Iannuzzo G, Abate V, Strazzullo P, Falchetti A. Idiopathic Osteoporosis and Nephrolithiasis: Two Sides of the Same Coin? Int J Mol Sci 2020; 21:ijms21218183. [PMID: 33142950 PMCID: PMC7662860 DOI: 10.3390/ijms21218183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022] Open
Abstract
Idiopathic osteoporosis and nephrolithiasis are formidable health problems showing a progressive increase in their incidence and prevalence in the last decades. These temporal trends were observed in both pediatric and adult populations worldwide. Epidemiological and experimental studies indicate that both disorders show several common pathogenic environmental and genetic factors. In this review, we analyzed the clinical characteristics common to the two disorders and the state-of-the-art knowledge regarding the genetic predisposition and the environmental factors recognized as triggers in adult and pediatric ages. As a result of this work, we propose to consider idiopathic nephrolithiasis and osteoporosis as two possible expressions of a unique clinical syndrome. Accordingly, the clinical approach to both disorders should be modified in order to program an efficient primary and secondary prevention strategy.
Collapse
Affiliation(s)
- Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d’Endocrinologie et Diabétologie Pédiatrique, 75019 Paris, France;
- French Clinical Research Group in Adolescent Medicine and Health, 75014 Paris, France
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Veronica Abate
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (D.R.); (G.I.); (V.A.); (P.S.)
| | - Alberto Falchetti
- Unit of Bone and Mineral Metabolic Diseases, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy
- Istituto Auxologico Italiano, IRCCS, Unit for Bone Metabolism Diseases and Diabetes & Lab of Endocrine and Metabolic Research, 20145 Milan, Italy
- Correspondence: ; Tel.: +39-33-1689-2204
| |
Collapse
|
3
|
The Risk of Nephrolithiasis Among Patients With Ankylosing Spondylitis: a Population-Based Cohort Study. Arch Rheumatol 2016; 31:346-352. [PMID: 30375555 DOI: 10.5606/archrheumatol.2016.5938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/24/2016] [Indexed: 12/17/2022] Open
Abstract
Objectives This study aims to investigate the correlation of ankylosing spondylitis (AS) with nephrolithiasis by performing a nationwide population- based cohort study. Patients and methods The data used in this retrospective cohort study were collected from the Taiwan National Health Insurance Research database. The study included a total of 3,334 AS patients (1,914 males, 1,420 females; mean age 44.51±16.83 years; range 22 to 79 years) and 13,336 non-AS patients (7,656 males, 5,680 females; mean age 44.27±17.01 years; range 21 to 78 years) who had been followed-up on an average of 6.78 years and 6.75 years, respectively, between January 2000 and December 2008. Results The percentage of newly diagnosed nephrolithiasis was 4.8% in all study subjects. However, the percentages of newly diagnosed nephrolithiasis were 5.76% and 4.58% in the AS and non-AS cohorts, respectively. After adjusting the patients' sex, age, urbanization level, and comorbidities, the hazard ratio obtained from our multivariable Cox model was 1.19. Conclusion Our study findings indicate that patients with AS are more likely to develop nephrolithiasis than non-AS patients.
Collapse
|
4
|
Girón-Prieto MS, Arias-Santiago S, Del Carmen Cano-García M, Poyatos-Andújar A, de Haro-Muñoz T, Abad-Menor F, Quesada-Charneco M, Arrabal-Polo MÁ, Arrabal-Martín M. Bone remodeling markers as lithogenic risk factors in patients with osteopenia-osteoporosis. Int Urol Nephrol 2016; 48:1777-1781. [PMID: 27376897 DOI: 10.1007/s11255-016-1361-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/28/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE To analyze the presence of phosphocalcic metabolism disorders in patients with osteopenia-osteoporosis without nephrolithiasis with respect to a control group. METHODS A cross-sectional study was conducted in patients with osteopenia-osteoporosis without nephrolithiasis (n = 67) in lumbar spine or femur and in a control group (n = 61) with no lithiasis or bone disorders. Blood bone markers, phosphocalcic metabolism, fasting urine, 24-h urine lithogenic risk factors, and densitometry were recorded in both groups. SPSS 20.0 was used for statistical analysis. RESULTS In comparison with the controls, significantly higher blood calcium (9.27 ± 0.36 vs. 9.57 ± 0.38, p = 0.0001), intact parathormone (45.6 ± 14.9 vs. 53.8 ± 18.9, p = 0.008), and alkaline phosphatase (61.9 ± 20.9 vs. 70.74 ± 18.9, p = 0.014) levels were found in patients with osteopenia-osteoporosis. In the 24-h urine test, citrate (1010.7 ± 647.8 vs. 617.6 ± 315.8, p = 0.0001) and oxalate (28.21 ± 17.65 vs. 22.11 ± 16.49, p = 0.045) levels were significantly lower in osteopenia-osteoporosis patients than in controls, with no significant difference in calcium (187.3 ± 106.9 vs. 207.06 ± 98.12, p = 0.27) or uric acid (540.7 ± 186.2 vs. 511.9 ± 167.06, p = 0.35) levels. Patients with osteopenia-osteoporosis had significantly higher levels of lithogenic risk factors associated with bone remodeling, including significantly increased β-crosslaps and osteocalcin values and higher β-crosslaps/osteocalcin ratios. CONCLUSION Patients with osteopenia-osteoporosis without nephrolithiasis showed phosphocalcic metabolism disorders as well as lower urinary citrate and higher β-crosslaps/osteocalcin and fasting calcium/creatinine ratios, which would increase the risk of nephrolithiasis. Hence, prospective studies are warranted to evaluate the long-term risks.
Collapse
Affiliation(s)
- María Sierra Girón-Prieto
- Centro de Salud de Pinos Puente, Programa de Doctorado de Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain
| | | | - María Del Carmen Cano-García
- UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain.,Instituto IBS Granada, Granada, Spain
| | | | | | - Felix Abad-Menor
- UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain.,Instituto IBS Granada, Granada, Spain
| | | | - Miguel Ángel Arrabal-Polo
- UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain. .,Instituto IBS Granada, Granada, Spain.
| | - Miguel Arrabal-Martín
- UGC Urologia, Complejo Hospitalario Universitario Granada, Dr Virgili street, 9, bajo C. Huercal Overa, 04600, Granada, Spain.,Instituto IBS Granada, Granada, Spain
| |
Collapse
|
5
|
Rull MAOH, Cano-García MDC, Arrabal-Martín M, Arrabal-Polo MA. The importance of urinary calcium in postmenopausal women with osteoporotic fracture. Can Urol Assoc J 2015; 9:E183-6. [PMID: 26085877 DOI: 10.5489/cuaj.2695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Calcium stones are associated with osteoporosis and manifested mainly by elevated fasting urinary calcium/creatinine ratio. The objective of this study is to demonstrate the presence of abnormal metabolism of calcium and calciuria in women with osteoporotic fracture with no previously known renal lithiasis compared to women without osteoporosis and without renal lithiasis. METHODS In total, 87 women were included in the study. They were divided into two groups: Group 1 with 55 postmenopausal women with osteoporotic fracture and without renal lithiasis; and Group 2 with 32 postmenopausal women without osteoporosis and without history of renal lithiasis. The following parameters of phospho-calcium metabolism were analyzed: calciuria 24-hour, oxaluria 24-hour, uricosuria 24-hour, and citraturia 24-hour. The presence of hypercalciuria, hyperoxaluria, hyperuricosuria, and hypocitraturia was compared between groups. Statistical significance was set at p ≤ 0.05. RESULTS The mean age was 70.1 ± 13.8 in Group 1 and 56.7 ± 6.4 in Group 2 (p = 0.0001). Women in Group 1 had higher levels of serum alkaline phosphatase (p < 0.05) and fasting urinary calcium/creatinine ratio (p < 0.05). The percentage of patients with hypercalciuria in Group 1 (40%) was higher compared to Group 2 (18.8%) and statistically significant (p = 0.04). There were no statistically significant differences in the percentage of hyperoxaluria, hyperuricosuria, and hypocitraturia between groups. This study has its limitations including its cross-sectional nature at a unique centre and its low number of patients. CONCLUSION The determination of urinary calcium and fasting calcium/creatinine ratio in postmenopausal women with osteoporotic fracture without renal lithiasis may facilitate individualization of medical therapy and decreasing lithogenic risk.
Collapse
Affiliation(s)
| | | | - Miguel Arrabal-Martín
- Urology Department, Complejo Hospitalario Universitario Granada, Instituto IBS Granada, Granada, Spain
| | | |
Collapse
|
6
|
Ochoa-Hortal Rull MÁ, Cano-García MC, Arrabal Martín M, Cano Gea R, Reyes García R, Arrabal-Polo MA. Calcium and phosphorus metabolism and lithogenic factors in patients with osteoporotic fracture. Actas Urol Esp 2015; 39:279-82. [PMID: 25709002 DOI: 10.1016/j.acuro.2014.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 12/10/2014] [Accepted: 12/12/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To demonstrate the attendance of mineral metabolism disorders and lithogenic factors in patients' urine with osteoporotic fracture without previously known stones MATERIAL AND METHODS 67 patients with osteoporotic fractures surgically treated in trauma service are included. The area of the fracture site, fracture mechanism and the presence of osteoporosis were the factors taken into account to diagnose osteoporotic fracture. Mineral metabolism, calciuria, oxaluria, uricosuria and citraturia in 24hours urine were analyzed. The presence of abnormal calcium and phosphorus metabolism was proved comparing hypercalciuria patients with normocalciuria ones. RESULTS 12 men and 55 women with mean age 68.8±14.5 years old were included. Mean Body Mass Index (BMI) was 27.4±4.1kg/m2. 42% of patients showed hypercalciuria, 34% hyperoxaluria, 34% hypocitraturia and 7% hyperuricosuria. Statistically significant differences were observed only in fasting calcium/creatinine ratio (0.17 vs. 0.08; P<.0001) when comparing patients with hypercalciuria with those with normocalciuria. CONCLUSIONS Patients with osteoporotic fractures show different lithogenic factors in urine, mainly hypercalciuria, always in fasting conditions.
Collapse
Affiliation(s)
- M Á Ochoa-Hortal Rull
- Servicio de Cirugía, Ortopedia y Traumatología, Hospital Rafael Méndez, Lorca, España
| | - M C Cano-García
- UGC Urología Intercentros, Hospital La Inmaculada, Huércal Overa, España
| | - M Arrabal Martín
- UGC Urología Intercentros, Hospital San Cecilio, Granada, España
| | - R Cano Gea
- Servicio de Cirugía, Ortopedia y Traumatología, Hospital Rafael Méndez, Lorca, España
| | - R Reyes García
- Servicio de Endocrinología y Nutrición Clínica, Hospital Rafael Méndez, Lorca, España
| | - M A Arrabal-Polo
- UGC Urología Intercentros, Hospital La Inmaculada, Huércal Overa, España.
| |
Collapse
|
7
|
Arrabal-Polo MA, Arrabal-Martin M. Stones: Bone health in patients with kidney stones. Nat Rev Urol 2014; 12:9-10. [PMID: 25487049 DOI: 10.1038/nrurol.2014.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Miguel Angel Arrabal-Polo
- Urology Department, La Inmaculada Hospital, Doctora Ana Parra Avenue, 04600 Huercal-Overa, Almeria, Spain
| | - Miguel Arrabal-Martin
- Urology Department, San Cecilio University Hospital, Doctor Oloriz Avenue, 18012 Granada, Spain
| |
Collapse
|