Urine Calcium and Bone Mineral Density in Calcium Stone-Forming Patients Treated with Alendronate and Hydrochlorothiazide

• Published in: Urologia internationalis Vol. 97; no. 3; p. 292
• Main Authors: Arrabal-Martín, Miguel, González-Torres, Samuel, Cano-García, María Del Carmen, De Haro-Muñoz, Tomás, Abad-Menor, Félix, Arrabal-Polo, Miguel Ángel, Cózar-Olmo, José Manuel
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2016
• Subjects: Alendronate - pharmacology; Alendronate - therapeutic use; Bone Density - drug effects; Bone Density Conservation Agents - pharmacology; Bone Density Conservation Agents - therapeutic use; Calcium - chemistry; Calcium - urine; Diuretics - pharmacology; Diuretics - therapeutic use; Female; Follow-Up Studies; Humans; Hydrochlorothiazide - pharmacology; Hydrochlorothiazide - therapeutic use; Kidney Calculi - drug therapy; Kidney Calculi - urine; Male; Middle Aged; Prospective Studies; Recurrence; Time Factors
• ISSN: 1423-0399
• DOI: 10.1159/000443484

The objective was to evaluate the effect of hydrochlorothiazide and alendronate on urine calcium and bone mineral density in calcium stone-forming patients. A prospective, non-randomized, non-observational comparative study was performed; this study included 111 patients with recurrent calcium stones, divided into 3 groups according to the treatment received. Group 1: 36 patients were treated with alendronate, 70 mg/week; Group 2: 34 patients were treated with alendronate, 70 mg/week + hydrochlorothiazide, 50 mg/day; Group 3: 41 patients were treated with hydrochlorothiazide, 50 mg/day. All patients received recommendations on diet and fluid intake. Other variables of bone mineral density were studied and analyzed, including bone remodeling markers and urinary calcium before and after 2 years of treatment. The statistical analysis was performed using the SPSS 17.0 program, with a statistical significance of p < 0.05. After 2 years of treatment, a significant difference was observed in the β-crosslaps and a bone mineral density improvement in Group 1, along with a decrease in urinary calcium. In Group 3, a statistically significant difference was found in urinary calcium and fasting calcium/creatinine ratio, as well as an improvement in bone mineral density after 2 years of medical treatment. In Group 2 patients treated with the combination, there was an improvement in bone mineral density and a decrease in the β-crosslaps marker similar to patients in Group 1, and a decrease in urinary calcium similar to those in Group 3. Combined alendronate + hydrochlorothiazide treatment offers the best results along with the improvement in bone mineral density and decrease in urine calcium in patients with recurrent calcium stones.