Hypercalciuria is a common and important finding in postmenopausal women with osteoporosis

Department of Medical and Surgical Sciences, Clinica Medica 1, University of Padua, Padua, Italy. sandro.giannini@unipd.it

OBJECTIVE AND DESIGN: The prevalence and the effects of hypercalciuria on bone in patients with primary osteoporosis are poorly defined. We therefore retrospectively analyzed the data of 241 otherwise healthy women. They were 45-88 years of age and had been referred for their first visit to our Unit for Metabolic Bone Diseases over a 2-year period because of primary osteoporosis (bone density T-score < -2.5). METHODS: The main parameters of calcium and skeletal metabolism had been analyzed in all subjects. This population was then divided into two groups, according to the presence (HC+) or absence (HC-) of hypercalciuria. RESULTS: Elevated urinary calcium was present in 19% of the subjects. Due to the selection criteria, spinal and femoral bone loss was similar in the two groups. Urinary calcium, phosphate and fractional calcium excretion were higher in hypercalciuric patients. In a logistic regression model, the higher the Tm of phosphate, the lower the risk of hypercalciuria (odds ratio 0.33, confidence interval 0.18-0.62). On the contrary, hypercalciuria was the most important predictor of low bone mass in HC+ (accounting for more than 50% of the variance in spinal bone density). CONCLUSIONS: Hypercalciuria is a common feature in postmenopausal bone loss. Since increased urinary calcium excretion and low bone mass appear to be linked, hypercalciuria seems to be an important determinant of reduced bone density in this setting as well.

This article has been cited by other articles:

				A. Giusti, A. Barone, G. Pioli, G. Girasole, V. Siccardi, E. Palummeri, and G. Bianchi Alendronate and indapamide alone or in combination in the management of hypercalciuria associated with osteoporosis: a randomized controlled trial of two drugs and three treatments Nephrol. Dial. Transplant., December 15, 2008; (2008) gfn690v1. [Abstract] [Full Text] [PDF]

				N. Ashton, S. H. Al-Wasil, H. Bond, J. L. Berry, J. Denton, and A. J. Freemont The effect of a low-protein diet in pregnancy on offspring renal calcium handling Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2007; 293(2): R759 - R765. [Abstract] [Full Text] [PDF]

				P. F. Lata and M. E. Elliott Patient Assessment in the Diagnosis, Prevention, and Treatment of Osteoporosis Nutr Clin Pract, June 1, 2007; 22(3): 261 - 275. [Abstract] [Full Text] [PDF]

				T. Remer and S. Berkemeyer Letter re: Persistent Hypocalciuric Effect of Potassium Bicarbonate in Postmenopausal Women J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4980 - 4981. [Full Text] [PDF]

				L. Frassetto, R. C. Morris Jr., and A. Sebastian Long-Term Persistence of the Urine Calcium-Lowering Effect of Potassium Bicarbonate in Postmenopausal Women J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 831 - 834. [Abstract] [Full Text] [PDF]