Published online Jul 25, 2021. doi: 10.5527/wjn.v10.i4.47
Peer-review started: April 1, 2021
First decision: July 8, 2021
Revised: July 18, 2021
Accepted: July 22, 2021
Article in press: July 22, 2021
Published online: July 25, 2021
Processing time: 129 Days and 3.2 Hours
Idiopathic hypercalciuria (IH) is the leading metabolic risk factor for pediatric urolithiasis. The reduction in bone mass has already been described in hypercalciuric children. Life-long hypercalciuria might be considered a risk to change bone structure and determine low bone mass throughout life. A beneficial effect of citrate formu
Considering that HI can cause a reduction in mineral bone density in children and adolescents and lead to osteopenia, osteoporosis, and an increased risk of fractures in adulthood, it would be important to know how to diagnose and treat this metabolic disorder.
Evaluated whether pharmacological therapy has a beneficial effect on bone mass in children and adolescents with IH.
This is a retrospective cohort study that evaluated hypercalciuric children non-responsive to lifestyle and diet changes. They were treated with potassium Kcitrate or with Kcitrate combined to thiazides. Before and after treatment they underwent bone densitometry.
Forty IH children, median age 10.5 years and median time follow-up 6.0 years, were evaluated. Nine patients were treated with Kcitrate (G1) and 31 with Kcitrate + thiazide (G2). Calciuria decreased in both groups after treatment. Lumbar spine bone mineral density z-score increased after thiazide treatment in G2. There was no improve
Results point to a beneficial effect of thiazide on lumbar spine bone mineral density z-score in children with IH.
Future perspectives are to understand better the pathogenesis of HI in order to treat children and adolescents, preventing bone mass reduction.