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Histomorphometric analysis of bone in idiopathic hypercalciuria before and after treatment with thiazide
Author(s) -
STEINICHE T.,
MOSEKILDE L.,
CHRISTENSEN M. S.,
MELSEN F.
Publication year - 1989
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/j.1699-0463.1989.tb00792.x
Subject(s) - hypercalciuria , endocrinology , medicine , osteoid , creatinine , thiazide , calcium , bone remodeling , alkaline phosphatase , urinary system , urinary calcium , chemistry , iliac crest , urology , diuretic , surgery , biochemistry , enzyme
Twenty‐seven normocalcemic patients aged 11–69 yrs with recurrent renal stone formation and idiopathic hypercalciuria were studied before and after treatment with hydrochlorthiazide (TD) 50 mg twice a day for 6 months. Hypercalciuria was defined as a 24 h renal calcium excretion of more than 7.5 mmol for males and 6.3 mmol for females. Quantitative histomorphometric analysis of illiac crest bone biopsies were performed before and after treatment. TD treatment increased the adjusted serum calcium level (p < 0.01), whereas no significant effects on the serum levels of phosphorous, alkaline phosphatase or iPTH were found. The urinary calcium/creatinine ratio decreased (p < 0.01) during TD treatment, whereas no change in the urinary phosphorous/creatinine ratio was found. The histomorphometric analysis revealed a reduction in the extent of eroded surfaces (p < 0.05) and bone formation rate (p < 0.05) as well as a decrease in the osteoid thickness (p < 0.05) during TD treatment. No effect on the trabuceluar bone volume was found. A reduction in the activation frequency of new remodeling sites and thereby a reduced bone turnover during TD treatment can explain the observed histomorphometric changes. The decrease in osteoid thickness may be related to the increased serum calcium concentration leading to better conditions for mineralization.