Low bone mineral density is a potential risk factor for symptom onset and related with hypocitraturia in urolithiasis pa
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RESEARCH ARTICLE
Open Access
Low bone mineral density is a potential risk factor for symptom onset and related with hypocitraturia in urolithiasis patients: a single‑center retrospective cohort study Kazumi Taguchi, Shuzo Hamamoto* , Atsushi Okada, Yutaro Tanaka, Teruaki Sugino, Rei Unno, Taiki Kato, Ryosuke Ando, Keiichi Tozawa and Takahiro Yasui
Abstract Background: Patients with urolithiasis have a lower bone mineral density (BMD) than those without stones, suggesting a potential correlation between calcium stone formation and bone resorption disorders, including osteopenia and osteoporosis. Methods: To investigate the influence of BMD on clinical outcomes in urolithiasis, we performed a single-center retrospective cohort study to analyze patients with urolithiasis who underwent both BMD examination and 24-h urine collection between 2006 and 2015. Data from the national cross-sectional surveillance of the Japanese Society on Urolithiasis Research in 2015 were utilized, and additional data related to urinary tract stones were obtained from medical records. The primary outcome was the development of stone-related symptoms and recurrences during follow-up. A total of 370 patients were included in this 10-year study period. Results: Half of the patients had recurrent stones, and the two-thirds were symptomatic stone formers. While only 9% of patients had hypercalciuria, 27% and 55% had hyperoxaluria and hypocitraturia, respectively. There was a positive correlation between T-scores and urinary citrate excretion. Both univariate and multivariate analyses demonstrated that female sex was associated with recurrences (odds ratio = 0.44, p = 0.007), whereas a T-score 2.5 L/day) and nutrition (increasing calcium-rich food and vegetables/fruits and reducing sodium and animal protein intake), which were obtained from the electronic medical records.
Methods Study design and patient selection
This retrospective cohort study was conducted at Nagoya City University (NCU) Hospital, a high-volume center. The institutional review board (IRB) approval was obtained from the medical research review board at NCU Graduate School of Medical Sciences (#60-19-0044), as well as Chiba University Graduate School of Medicine (#1962), Kanazawa Medical University (#226), and Osaka City University (#970) as national cross-sectional surveillance. The patients provided written informed consent. At the time of the national cross-sectional survey by the Japanese Society on Urolithiasis Research in 2015, all our patients with urinary stone disease diagnosed by radiographic evidence were included, as previously reported
Fig. 1 Study design chart. *Examined for high-risk stone formers using at least one collection after surgical intervention and/or during clinic follow-up. #Examined for high-risk stone formers with suspicion of bone mineral abnormalities within 6 months of 24-h urine collection. NCU, Nagoya City University Hospital; BMD, bone mineral density
Taguchi et al. BMC Urol
(2020) 20:174
BMD was measured from the lumbar vertebra
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