Impact of urinary calcium excretion on kidney, bone, and cardiovascular systems in patients with bone biopsy proven osteoporosis: a longitudinal long-term follow-up study
Authors' conclusion
UCaE correlated with eGFR but it did not affect the change of eGFR over time. Patients with normal UCaE had lower incidence of upper limb fractures and less reduction in BMD. Low UCaE predicted MACE and CVD.
Study context
- Population
- Patients with bone biopsy proven osteoporosis who underwent bone biopsy and 24-h urine collection, 2008–2015, University of Kentucky; secondary osteoporosis excludedmean follow-up 7.2 ± 2.9 years
- Participants
- 230 patients
- Exposure
- Levels of urinary calcium excretion
- Outcome
- Kidney, bone and cardiovascular outcomes by UCaE
Methodological detailssingle-centre, multi-variable regression
- Single-centre
- Multi-variable regression
Main finding
As reported in the abstract
- Urinary calcium excretion (UCaE) correlated positively with eGFR but did not affect the rate of eGFR decline over time
- Higher UCaE predicted kidney stones development
- Hypercalciuria predicted loss of BMD at all sites; hypocalciuria associated with higher loss in total hip BMD (U-shaped effect)
- Upper limb fractures (most observed) more frequent with hyper- or hypo-calciuria
- Lower UCaE independently predicted major adverse cardiac events (MACE) and cardiovascular disease (CVD)
Observational data: associations, not effects.
Further findings
Hypercalciuria prevalence
- Hypercalciuria in one-third of patients, no difference between low and high bone turnover
Original publication
Impact of urinary calcium excretion on kidney, bone, and cardiovascular systems in patients with bone biopsy proven osteoporosis: a longitudinal long-term follow-up study. Osteoporos Int. Published 15 February 2023. doi:10.
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