İdiopatik normokalsiürik rekürren üriner sistem kalsiyum taşlı hastalarda potasyum sitrat’ın kemik mineral yoğunluğu üzerine etkisi

Giriş: Bu çalışmada idiopatik normokalsiürik rekürren üriner sistem kalsiyum taşlı hastalarda potasyum sitratın kemik dansitesine etkinliği incelendi. Gereç ve Yöntemler: Çalışmaya daha önce en az 2 kez taş düşüren, yaşları 18 ile 51 yıl arasında değişen, 16’sı kadın ve 14’ü erkek toplam 30 hasta alındı. Tüm hastalarda standart metabolik, endokrinolojik tetkikler ve 24 saatlik idrar analizi incelendi. Çalışma grubuna sadece normokalsiürik rekürren üriner sistem kalsiyum taşlı hastalar dahil edildi. Hastaların hiçbirinde kalsiyum ve kemik metabolizmasını etkileyecek herhangi bir hastalık bulunmuyordu. Her hastanın boyu (cm) ve vücut ağırlığı (kg) ölçüldü ve vücut kitle indeksi (VKİ) hesaplandı. Çalışmaya alınan hastaların diyetle sodyum (100 mEq/gün) ve oksalat alımları kısıtlandı. Hastalara 6-18 ay boyunca 60 mEq/gün potasyum sitrat (Urocit-K) tedavisi verildi ve tedavi öncesi ve sonrasında total femur ve L2-4 vertebra KMY (Kemik Mineral Yoğunluğu) ve Z-skoru ölçüldü. Bulgular: Çalışmaya alınan erkeklerin yaş ortalaması 34.5 ± 8 yıl, kadınların yaş ortalaması 32.18 ± 6 yıl idi. VKİ; erkeklerde 24.8 ± 1.9 kg/m2, kadınlarda ise 22.6 ± 1.5 kg/m2 idi. Hastaların tedavi öncesi ve sonrasındaki kan biyokimya sonuçları değerlendirildiğinde tedavi sonrası kan parametrelerinde ve idrar kalsiyum değerinde istatistiksel anlamı olan bir değişimin olmadığı ve tüm değerlerin normal sınırlarda olduğu saptandı (p > 0.05). Her iki cinsiyette tedavi sonrasında, tedavi öncesine göre idrar sitrat düzeyinde istatistiksel olarak anlamlı artış oldu (p < 0.05). L2-4 vertebralarda ve femur totalde Z-skoru değerleri tedavi öncesine göre anlamlı olarak daha yüksek bulundu (p

Impact of potassium citrate on bone mineral density in patients with idiopathic normocalciuric recurrent urinary system calcium stones

Objective: We investigated the impact of potassium citrate on bone mineral density in patients with idiopathic normocalciuric recurrent urinary system calcium stones. Materials and Methods: A total of 30 patients, aged between 18 and 51 years, including 16 women and 14 men with personel history of at least 2 kidney stones were enrolled in the study. Standard metabolic, endocrine and 24-hour urine tests were performed. Only those with a diagnosis of idiopathic normocalsiuric calsium stone were included in the study group. None of the patients had any disease that may affect calcium and bone metabolism. The body mass index was calculated for each subject. Dietary sodium and oxalate intake were limited during study. Total femur and L2-4 bone mineral density and Z-scores were calculated in patients before and after treatment with 60 mEq/day potassium citrate for 6-18 months. Results: The mean ages of men and women were 34.5±8 and 32.18±6 consecutively. BMI of men was 24.8±1.9kg/m2 and women was 22.6±1.5kg/m2 . There were no statistically significant change in the serum biochemical parameters and urine calcium level after treat- ment (p>0.05). Urine citrate level was significantly elevated for both genders (p<0.05). L2-4 vertebrate and femur bone mineral density and Z-score were significantly better after treatment (p<0.05). Conclusion: Potassium citrate, a systemic alkylating agent can be beneficial to prevent bone mineral density loss in patients with nor- mocalciuric urolithiasis. However prospective studies with longer follow up duration and larger study population is needed to evaluate the efficacy.

Kaynakça

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Kaynak Göster

Yeni Üroloji Dergisi
  • ISSN: 1305-2489
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2005

838172

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