The impact of nephrolithiasis on skeletal growth and bone health across the life span of kidney stone formers is reviewed.
Bone disease is an early event among kidney stone formers (SF), with distinct phenotypes according to each age, sex, menopausal status, dietary, hormonal and genetic factors. Nephrolithiasis-associated bone disorder is characterized by reduced bone mineral density (BMD) and histologically discloses low bone formation, high bone resorption and abnormal mineralization. Although hypercalciuria has been presumed to be pathogenic for bone loss in SF, the association of BMD with urinary calcium is not uniform in all studies. Hypocitraturia, metabolic disturbances, cytokines and receptors, growth factors and acid-base status may all influence skeletal outcomes. The potential link of bone disease with vascular calcification and cardiovascular disease among SF is discussed. The unique vulnerability of the younger skeleton to the effects of nephrolithiasis on attainment of peak bone mass and strength is highlighted and the association of bone loss with kidney stone formation early in life indicate the opportunity for intervention to reduce the risk of future bone fractures.
Current osteoporosis reports. 2024 Oct 02 [Epub ahead of print]
Ita Pfeferman Heilberg, Aluizio Barbosa Carvalho, Michelle R Denburg
Nephrology Division, Department of Medicine, Universidade Federal de São Paulo, Rua Botucatu 740 - Vila Clementino, São Paulo, 04023-900, Brazil. ., Nephrology Division, Department of Medicine, Universidade Federal de São Paulo, Rua Botucatu 740 - Vila Clementino, São Paulo, 04023-900, Brazil., Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.