Ita Pfeferman Heilberg, Aluizio Barbosa Carvalho, Michelle R Denburg
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引用次数: 0
Abstract
Purpose of review: The impact of nephrolithiasis on skeletal growth and bone health across the life span of kidney stone formers is reviewed.
Main findings: Bone disease is an early event among kidney stone formers (SF), with distinct phenotypes according to each age, sex, menopausal status, dietary, hormonal and genetic factors. Nephrolithiasis-associated bone disorder is characterized by reduced bone mineral density (BMD) and histologically discloses low bone formation, high bone resorption and abnormal mineralization. Although hypercalciuria has been presumed to be pathogenic for bone loss in SF, the association of BMD with urinary calcium is not uniform in all studies. Hypocitraturia, metabolic disturbances, cytokines and receptors, growth factors and acid-base status may all influence skeletal outcomes. The potential link of bone disease with vascular calcification and cardiovascular disease among SF is discussed. The unique vulnerability of the younger skeleton to the effects of nephrolithiasis on attainment of peak bone mass and strength is highlighted and the association of bone loss with kidney stone formation early in life indicate the opportunity for intervention to reduce the risk of future bone fractures.
综述的目的:主要研究结果:主要发现:骨病是肾结石患者(SF)的早期症状,根据不同的年龄、性别、绝经状态、饮食、激素和遗传因素而表现出不同的表型。肾结石相关骨病的特点是骨矿物质密度(BMD)降低,组织学显示骨形成低、骨吸收高和矿化异常。虽然高钙尿症被认为是 SF 骨质流失的致病因素,但并非所有研究都将 BMD 与尿钙联系在一起。低钙尿症、代谢紊乱、细胞因子和受体、生长因子和酸碱状态都可能影响骨骼结果。本文还讨论了自费人群中骨病与血管钙化和心血管疾病的潜在联系。强调了年轻骨骼在肾结石对达到峰值骨量和骨强度的影响方面的独特脆弱性,以及骨质流失与生命早期肾结石形成的关联,表明有机会采取干预措施以降低未来骨折的风险。
期刊介绍:
This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.