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Central European Journal of Medicine

, Volume 7, Issue 4, pp 429–434 | Cite as

Alendronate in patients with calcium nephrolithiasis and loss of bone mass

  • Miguel Angel Arrabal-Polo
  • Miguel Arrabal-Martin
  • Salvador Arias-Santiago
  • Armando Zuluaga-Gomez
Research Article
  • 67 Downloads

Abstract

Background

Our purpose is to show the effect of alendronate on patients with recurrent calcium lithiasis and loss of bone mass, and to observe their progress with analytical and densitometric markers.

Methods

We present a unique cohort (before and after study) of 15 patients with recurrent calcium nephrolithiasis and loss of bone mass treated for three years with 70 mg sodium alendronate weekly. The sample is divided into two groups by sex (5 men and 10 women, aged 35–65 years). We assessed clinical progress of both bone and lithiasic disease and urine and plasma markers of both pathologies.

Results

We obtained a significant decrease in calcuria levels after 3 years of treatment (15.1 vs. 10.1; p=0.01), fasting calcium/creatinine quotient (0.16 vs. 0.10; p=0.002), and β-crosslaps (0.596 vs. 0.501; p=0.01). Moreover, we observed a disease stabilization in 14 of the 15 patients (93.3%), and, in all patients, bone mineral density had improved. Neither side effects nor losses of patients were observed after 3 years of treatment.

Conclusions

The use of weekly alendronate in patients with recurrent calcium lithiasis and loss of bone mass is safe and effective, curbs lithiasic disease progression, and improves bone mineral density.

Keywords

Alendronate Calcium stones Bone density loss 

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References

  1. [1]
    Arrabal Martín M, Fernández Rodríguez A, Arrabal Polo MA, Ruíz García MJ, Zuluaga Gómez A. Study of the physical-chemical factors in patients with renal lithiasis. Arch Esp Urol. 2006; 59:583–594PubMedGoogle Scholar
  2. [2]
    Arrabal Martín M, Díaz de la Guardia FV, Jiménez Pacheco A, López León V, Arrabal Polo MA, Zuluaga Gómez A. The treatment of renal lithiasis with biphosphonates. Arch Esp Urol. 2007; 60:745–754PubMedCrossRefGoogle Scholar
  3. [3]
    Thorleifsson G, Holm H, Edvardsson V, Walters GB, Styrkarsdottir U, Gudbjartsson DF et al. Sequence variants in the CLDN14 gene associate with kidney stones and bone mineral density. Nat Genet. 2009; 41:926–930PubMedCrossRefGoogle Scholar
  4. [4]
    Cipriani Thorne E. Osteoporosis: Consideraciones diagnosticas y terapeuticas. Rev Med Hered. 2004; 15:101–107Google Scholar
  5. [5]
    Moro-Alvarez MJ, Cabrera JA. Osteoporosis in men. Rev Clin Esp. 2010; 210:342–349PubMedCrossRefGoogle Scholar
  6. [6]
    Morales Piga A. Advances in the treatment of osteoporosis at the beginning of the new millennium. Rev Clin Esp. 2002; 202:23–26PubMedGoogle Scholar
  7. [7]
    Watts NB, Diab DL. Long-term use of bisphosphonates in osteoporosis. J Clin Endocrinol Metab. 2010; 95:1555–1565PubMedCrossRefGoogle Scholar
  8. [8]
    Adrover Rigo M, Juste Diez de Pinos JL, Tuset Creus M, Codina Jane C, Ribas Sala J. Revision clínica de la utilización de los bifosfonatos. Farm Hosp. 2000; 24:74–82Google Scholar
  9. [9]
    Ravn P. Bisphosphonates for prevention of postmenopausal osteoporosis. Dan Med Bull. 2002; 49:1–18PubMedGoogle Scholar
  10. [10]
    Bonnick S, Broy S, Kaiser F, Teutsch C, Rosenberg E, DeLucca P et al. Treatment with alendronate plus calcium, alendronate alone, or calcium alone for postmenopausal low bone mineral density. Curr Med Res Opin. 2007; 23:1341–1349PubMedCrossRefGoogle Scholar
  11. [11]
    Ravn P, Clemmesen B, Christiansen C. Biochemical markers can predict the response in bone mass during alendronate treatment in early postmenopausal women. Alendronate Osteoporosis Prevention Study Group. Bone. 1999; 24:237–244Google Scholar
  12. [12]
    Murphy MG, Weiss S, McClung M, Schnitzer T, Cerchio K, Connor J et al. Effect of alendronate and MK-677 (a growth hormone secretagogue), individually and in combination, on markers of bone turnover and bone mineral density in postmenopausal osteoporotic women. J Clin Endocrinol Metab. 2001; 86:1116–1125PubMedCrossRefGoogle Scholar
  13. [13]
    Pazianas M, Miller P, Blumentals WA, Bernal M, Kothawala P. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. Clin Ther. 2007; 29:1548–1558PubMedCrossRefGoogle Scholar
  14. [14]
    Abrahamsen B. Bisphosphonate adverse effects, lessons from large databases. Curr Opin Rheumatol. 2010; 22:404–409PubMedCrossRefGoogle Scholar
  15. [15]
    Venkatanarasimha N, Miles G, Suresh P. Subtrochanteric femoral insufficiency fractures related to the use of long-term biphosphonates: a pictorial review. Emerg Radiol. 2010; 17:511–515PubMedCrossRefGoogle Scholar
  16. [16]
    Abrahamsen B, Eiken P, Eastell R. Cumulative alendronate dose and the long-term absolute risk of subtrochanteric and diaphyseal femur fractures: a register-based national cohort analysis. J Clin Endocrinol Metab. 2010; 95:5258–5265PubMedCrossRefGoogle Scholar
  17. [17]
    Arrabal-Martín M, Fernández-Rodríguez A, Arrabal-Polo MA, García-Ruiz MJ, Zuluaga-Gómez A. Extracorporeal renal lithotripsy: evolution of residual lithiasis treated with thiazides. Urology. 2006; 68:956–959PubMedCrossRefGoogle Scholar
  18. [18]
    Sakhaee K, Maalouf N, Kumar R, Pasch A, Moe O. Nephrolithiasis-associated bone disease: pathogenesis and treatment options. Kidney Int. 2011; 79:393–403PubMedCrossRefGoogle Scholar
  19. [19]
    Legroux-Gerot I, Catanzariti L, Marchandise X, Duquesnoy B, Cortet B. Bone mineral density changes in hypercalciuretic osteoporotic men treated with thiazide diuretics. Joint Bone Spine. 2004; 71:51–55PubMedCrossRefGoogle Scholar
  20. [20]
    Bushinsky DA, Neumann KJ, Asplin J, Krieger NS. Alendronate decreases urine calcium and supersaturation in genetic hypercalciuric rats. Kidney Int. 1999; 55:234–243PubMedCrossRefGoogle Scholar
  21. [21]
    Ruml LA, Dubois SK, Roberts ML, Pak CY. Prevention of hypercalciuria and stone-forming propensity during prolonged bedrest by alendronate. J Bone Miner Res. 1995; 10:655–662PubMedCrossRefGoogle Scholar
  22. [22]
    Heller HJ, Zerwekh JE, Gottschalk FA, Pak CY. Reduced bone formation and relatively increased bone resorption in absorptive hypercalciuria. Kidney Int. 2007; 71:808–815PubMedCrossRefGoogle Scholar
  23. [23]
    Giusti A, Barone A, Pioli G, Girasole G, Siccardi V, Palummeri E et al. 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. 2009; 24:1472–1477PubMedCrossRefGoogle Scholar
  24. [24]
    Chandhoke PS. When is medical prophylaxis cost-effective for recurrent calcium stones? J Urol. 2002; 168:937–940PubMedCrossRefGoogle Scholar

Copyright information

© Versita Warsaw and Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Miguel Angel Arrabal-Polo
    • 1
  • Miguel Arrabal-Martin
    • 1
  • Salvador Arias-Santiago
    • 2
  • Armando Zuluaga-Gomez
    • 1
  1. 1.Urology DepartmentSan Cecilio University HospitalGranadaSpain
  2. 2.Medicine DepartmentGranada UniversityGranadaSpain

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