Low Bone Density and Bisphosphonate Use and the Risk of Kidney Stones
Copyright © 2017 by the American Society of Nephrology..
BACKGROUND AND OBJECTIVES: Previous studies have demonstrated lower bone density in patients with kidney stones, but no longitudinal studies have evaluated kidney stone risk in individuals with low bone density. Small studies with short follow-up reported reduced 24-hour urine calcium excretion with bisphosphonate use. We examined history of low bone density and bisphosphonate use and the risk of incident kidney stone as well as the association with 24-hour calcium excretion.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a prospective analysis of 96,092 women in the Nurses' Health Study II. We used Cox proportional hazards models to adjust for age, body mass index, thiazide use, fluid intake, supplemental calcium use, and dietary factors. We also conducted a cross-sectional analysis of 2294 participants using multivariable linear regression to compare 24-hour urinary calcium excretion between participants with and without a history of low bone density, and among 458 participants with low bone density, with and without bisphosphonate use.
RESULTS: We identified 2564 incident stones during 1,179,860 person-years of follow-up. The multivariable adjusted relative risk for an incident kidney stone for participants with history of low bone density compared with participants without was 1.39 (95% confidence interval [95% CI], 1.20 to 1.62). Among participants with low bone density, the multivariable adjusted relative risk for an incident kidney stone for bisphosphonate users was 0.68 (95% CI, 0.48 to 0.98). In the cross-sectional analysis of 24-hour urine calcium excretion, the multivariable adjusted mean difference in 24-hour calcium was 10 mg/d (95% CI, 1 to 19) higher for participants with history of low bone density. However, among participants with history of low bone density, there was no association between bisphosphonate use and 24-hour calcium with multivariable adjusted mean difference in 24-hour calcium of -2 mg/d (95% CI, -25 to 20).
CONCLUSIONS: Low bone density is an independent risk factor for incident kidney stone and is associated with higher 24-hour urine calcium excretion. Among participants with low bone density, bisphosphonate use was associated with lower risk of incident kidney stone but was not independently associated with 24-hour urine calcium excretion.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Clinical journal of the American Society of Nephrology : CJASN - 12(2017), 8 vom: 07. Aug., Seite 1284-1290 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Prochaska, Megan [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 30.04.2018 Date Revised 13.08.2023 published: Print-Electronic CommentIn: J Urol. 2018 Jan;199(1):22-23. - PMID 29310177 Citation Status MEDLINE |
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| doi: |
10.2215/CJN.01420217 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM272572896 |
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| 245 | 1 | 0 | |a Low Bone Density and Bisphosphonate Use and the Risk of Kidney Stones |
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| 500 | |a Date Completed 30.04.2018 | ||
| 500 | |a Date Revised 13.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Urol. 2018 Jan;199(1):22-23. - PMID 29310177 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Previous studies have demonstrated lower bone density in patients with kidney stones, but no longitudinal studies have evaluated kidney stone risk in individuals with low bone density. Small studies with short follow-up reported reduced 24-hour urine calcium excretion with bisphosphonate use. We examined history of low bone density and bisphosphonate use and the risk of incident kidney stone as well as the association with 24-hour calcium excretion | ||
| 520 | |a DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a prospective analysis of 96,092 women in the Nurses' Health Study II. We used Cox proportional hazards models to adjust for age, body mass index, thiazide use, fluid intake, supplemental calcium use, and dietary factors. We also conducted a cross-sectional analysis of 2294 participants using multivariable linear regression to compare 24-hour urinary calcium excretion between participants with and without a history of low bone density, and among 458 participants with low bone density, with and without bisphosphonate use | ||
| 520 | |a RESULTS: We identified 2564 incident stones during 1,179,860 person-years of follow-up. The multivariable adjusted relative risk for an incident kidney stone for participants with history of low bone density compared with participants without was 1.39 (95% confidence interval [95% CI], 1.20 to 1.62). Among participants with low bone density, the multivariable adjusted relative risk for an incident kidney stone for bisphosphonate users was 0.68 (95% CI, 0.48 to 0.98). In the cross-sectional analysis of 24-hour urine calcium excretion, the multivariable adjusted mean difference in 24-hour calcium was 10 mg/d (95% CI, 1 to 19) higher for participants with history of low bone density. However, among participants with history of low bone density, there was no association between bisphosphonate use and 24-hour calcium with multivariable adjusted mean difference in 24-hour calcium of -2 mg/d (95% CI, -25 to 20) | ||
| 520 | |a CONCLUSIONS: Low bone density is an independent risk factor for incident kidney stone and is associated with higher 24-hour urine calcium excretion. Among participants with low bone density, bisphosphonate use was associated with lower risk of incident kidney stone but was not independently associated with 24-hour urine calcium excretion | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Body Mass Index | |
| 650 | 4 | |a Bone Density | |
| 650 | 4 | |a Calcium, Dietary | |
| 650 | 4 | |a Cross-Sectional Studies | |
| 650 | 4 | |a Diphosphonates | |
| 650 | 4 | |a Epidemiologic Studies | |
| 650 | 4 | |a Female | |
| 650 | 4 | |a Follow-Up Studies | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Kidney Calculi | |
| 650 | 4 | |a Linear Models | |
| 650 | 4 | |a Proportional Hazards Models | |
| 650 | 4 | |a Prospective Studies | |
| 650 | 4 | |a Risk Assessment | |
| 650 | 4 | |a Thiazides | |
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| 700 | 1 | |a Vaidya, Anand |e verfasserin |4 aut | |
| 700 | 1 | |a Curhan, Gary |e verfasserin |4 aut | |
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