65 BONE DENSITY RESULTS OF VITAMIN-D INADEQUATE PATIENTS PRESENTING WITH UROLITHIASIS TO A TERTIARY STONE CENTER

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-Based Medicine & Outcomes (II)1 Apr 201365 BONE DENSITY RESULTS OF VITAMIN-D INADEQUATE PATIENTS PRESENTING WITH UROLITHIASIS TO A TERTIARY STONE CENTER Mohamed Elkoushy, Terence Lee, and Sero Andonian Mohamed ElkoushyMohamed Elkoushy Montreal, Canada More articles by this author , Terence LeeTerence Lee Montreal, Canada More articles by this author , and Sero AndonianSero Andonian Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1443AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Vitamin-D Inadequacy (VDI) and its associated metabolic abnormalities are prevalent in patients presenting with urolithiasis. Vitamin D plays a vital role in bone health and stone-formers are at risk of premature bone loss that may be exaggerated by VDI. Therefore, the aim of the present study was to assess abnormalities in bone density studies for patients with VDI presenting with urolithiasis to a tertiary stone clinic. METHODS A retrospective review of prospectively collected data was performed for patients presenting to stone clinic from November, 2009 to August, 2012. Demographic and clinical data were collected together with metabolic stone work-up and bone density studies. VDI was defined as VD levels < 30 ng/ml. A Dual-energy X-ray Absorptiometry (DXA) scan was used to evaluate the Bone Mineral Density (BMD) at the femoral neck and lumbar spine. The World Health Organization (WHO) criteria were used to define patients with abnormal BMD; normal (within ±1 SD), osteopenia (−1 to −2.5 SD), and osteoporosis (<−2.5 SD). Patients with primary hyperparathyroidism or hypercalcemia were excluded. RESULTS A total of 49 patients with VDI with DXA studies were included; 26 (53.1%) were males. Mean age (95%CI) was 51.5 (42.5-58.3) years, mean BMI (95%CI) was 27.9 (21.6- 31.2) kg/m2 and mean serum VD (95%CI) was 18.4 (16.4-26.2) ng/ml. Twenty-nine patients (59.2%) had abnormal DXA studies where 23 (46.9%) had osteopenia and 6(12.3%) had osteoporosis in the femoral neck and/or lumbar spine. Femoral neck was affected in 42.8% of patients (36.7% osteopenia and 6.1% osteoporosis) while lumbar spine was affected in 40.8% of patients (32.6% osteopenia and 8.2% osteoporosis; one patient had severe osteoporosis with history of osteoporotic fractures). Median serum VD (95%CI) was not significantly different between patients with normal and abnormal DXA scans [19.2 (8-29) vs. 17.2 (6-28) ng/ml, p=0.10). Similarly, median serum VD (95%CI) did not significantly differ between osteopenics and osteoporotics [17.6 (6-28) vs. 15.6 (6.8-23.6) ng/ml, p=0.64]. Of interest, 61.3% of those with abnormal DXA scans were males. CONCLUSIONS A high prevalence of abnormal DXA scans was found in patients presenting with urolithiasis and vitamin D inadequacy. These findings need to be taken into account during evaluation and replacement of vitamin D in this population. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e27 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Elkoushy Montreal, Canada More articles by this author Terence Lee Montreal, Canada More articles by this author Sero Andonian Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...