Schwaderer Andrew Lawrence, Kusumi Kirsten, Ayoob Rose Mary
aNationwide Children's Hospital, The Ohio State University, Department of Pediatrics, Division of Nephrology bThe Research Institute at Nationwide Children's Hospital, Center for Clinical and Translational Medicine cPediatric Nephrology Fellowship, Nationwide Children's Hospital, Ohio, USA.
Curr Opin Pediatr. 2014 Apr;26(2):207-14. doi: 10.1097/MOP.0000000000000069.
To review the recent publications describing the link between pediatric nephrolithiasis and bone metabolism.
Nephrolithiasis incidence is increasing in children and is associated with low bone mineral density (BMD). Affected children are conceptually at risk for fractures and osteoporosis. In addition to abnormal calcium metabolism, inflammation, genetic makeup and dietary habits are being recognized as important factors in the pathophysiology of nephrolithiasis and low bone density. Findings from retrospective reviews suggest that low BMD in children may be improved with citrate or thiazide treatment.
The healthcare burden from low BMD with subsequent osteoporosis and fracture risk is immense with potential far-reaching effects in patient quality of life and healthcare expense. Bone mass is acquired in the pediatric age range, thus it is important to identify and treat at-risk children. Retrospective reviews in pediatric patients indicate that citrate or thiazide diuretic treatment may improve BMD. We now understand that a relationship exists between nephrolithiasis and low BMD. To improve healthcare for our current patients as well as protect their future health it is important to identify low BMD and initiate strategies to improve BMD in 'at-risk' children.
综述近期描述小儿肾结石与骨代谢之间联系的出版物。
儿童肾结石发病率正在上升，且与低骨密度（BMD）相关。患病儿童理论上面临骨折和骨质疏松的风险。除了钙代谢异常外，炎症、基因构成和饮食习惯也被认为是肾结石和低骨密度病理生理学中的重要因素。回顾性研究结果表明，柠檬酸盐或噻嗪类药物治疗可能会改善儿童的低骨密度。
低骨密度以及随之而来的骨质疏松和骨折风险所带来的医疗负担巨大，对患者生活质量和医疗费用可能产生深远影响。骨量在儿童时期获得，因此识别和治疗高危儿童很重要。对儿科患者的回顾性研究表明，柠檬酸盐或噻嗪类利尿剂治疗可能会改善骨密度。我们现在了解到肾结石与低骨密度之间存在关联。为了改善当前患者的医疗状况并保护他们未来的健康，识别低骨密度并启动改善“高危”儿童骨密度的策略很重要。
