KIDNEY STONE DISEASE AND OSTEOPOROSIS -TOPIC ISSUES OF COMORBIDITY

Abstract

the prevalence of kidney stone disease (KSD) and osteoporosis (OP) increases every year. In the pre-vention of osteoporosis, it is important to consume a sufficient amount of calcium-rich foods in the daily diet, as
 well as the use of calcium. One of the important reasons for the insufficient use of calcium-containing products andmedicines is the anxiety not only of patients, but, very importantly, of doctors as much as possible. This has seriousjustification, as nephrolithiasis occurs in approximately 5% of the population, and the risk of developing kidneystones during life is 8-10%. It is believed that secondary hyperparathyroidism, which is caused by hypocalcemiadue to insufficient consumption of calcium-containing products and impaired renal function, leads to increasedbone resorption, formation of kidney stone disease. It is important to consider that against the background ofhypertensive, atherosclerotic kidney disease, tubulo-interstitial lesions of the kidneys with decreasing glomerularfiltration rate decreases the synthesis of 1α-hydroxylase - an enzyme by which 25-hydroxycholecalciferol (25 (OH)active D3, calcium) form of vitamin D3–1.25 dihydroxycholecalciferol (1.25 (OH) 2D3, calcitriol - D-hormone)and secondary hyperparathyroidism develops. In this case, the purpose of correction along with the treatment ofurolithiasis (spa treatment, given the attendance of the presence of KSD, to carry out the distance lithotripsy), intakeof active metabolites of vitamin D (should be started with low doses, independent of the initial PTH concentration,and then titrated based on the PTH response) conducting X-ray densitometry.