Renal osteodystrophy secondary to recurrent nephrolithiasis: choice of drug therapy

Yarovoy S.K., Sivkov A.V.

In the paper results of examination and treatment of 27 patients suff ering from recurrent phosphate nephrolithiasis which were treated at the Research Institute of Urology were analyzed. Patients with chronic renal failure grade II-III and hyperparathyroidism were excluded. Along with overall assessment of renal function (glomerular fi ltration rate, daily protein excretion, inorganic phosphate excretion etc.) and spectral analysis of excreted calculi, all patients underwent assessment for bone mineral density of calcaneal tuber by osteodensitometry using Calscan device (Lund, Sweden). High frequency (85,19%) of osteoporosis and osteopenia was observed in patients suff ering from recurrent phosphate nephrolithiasis, however there was no statistically signifi cant correlation between inorganic phosphate excretion rate and bone mineral density. High potency of alendronate therapy (Fosamax, Merck Sharp & Dohme, USA) was demonstrated, which involve signifi cant reducing inorganic phosphate renal excretion aft er 7 weeks treatment. Conclusion that metaphylaxis of phosphate nephrolithiasis is possible by means of bone metabolism drug modulation was made. Th e paper is supplemented by review of pharmaceutical drugs, that can be used for renal osteodystrophy treatment. Insuffi cient of regulatory system development on this problem is stated. Benefi ts of bisphosphonates as a drug of choice for treatment of renal osteodystrophy secondary to recurrent nephrolithiasis were established.