par Fuss, Michel
Référence Revue Francaise d'Endocrinologie Clinique - Nutrition et Metabolisme, 38, 4-5, page (273-282)
Publication Publié, 1997
Article révisé par les pairs
Résumé : Osteopenia is associated with idiopathic renal stone disease, presumably related to the low calcium diet, usually advised in this condition. When this is the case, patients show an accelerated bone metabolism, as suggested by high serum alkaline phosphatase activity and increased urinary excretion of hydroxyproline. These abnormalities are not explained by hyperparathyroidism, neither by calcitonin deficiency. Among possible causes, osteopenia could be related to hypophosphatemia, to renal hypercalciuria not compensated by appropriate calcium intake, or to exaggerated serum levels of 1,25 dihydroxyvitamin D, which were shown to be harmful for bone if calcium intake is reduced. Reduction of calcium intake thus should be avoided in the majority of renal stone formers. Treating hypercalciuria, if present, should better be achieved by reducing sodium intake and, when necessary, by using thiazide diuretics; these drugs control hypercalciuria and seem to have a protective effect on bone.