Nephrolithiasis and metabolic osteopathy due to somatic diseases

The aim of the study was to investigate the role of the co-morbidities (androgen deficiency, ischemic heart disease, diabetes mellitus type 2) in the pathogenesis of the secondary changes in the bone skeleton during the different forms of nephrolithiasis. The study included 193 patients from Clinical Hospital 47 (Moscow, Russia) and National Scientific Institute of Urology (Moscow, Russia). The decreases in the testosterone concentration affected negatively the mineral density of the bone tissue in patients with nephrolithiasis independent on causality. The concurrent increase of the parathyroid hormone concentration in patients with phosphate nephrolithiasis leads to the activation of the osteoclasts enhancing the detrimental bone effects of androgen deficiency. Concurrent ischemic heart disease with heart insufficiency in patients with nephrolithiasis is an important factor for secondary bone damage. The severity of the decreases in the mineral density of the bones is more in case of phosphate urolithiasis compared to the stones of other chemical genesis. In the basis of pathogenesis for decalcification of the bone lies the activation of the bone resorption. Concurrent diabetes mellitus of second type, even being compensated, leads to the decreases in the activity of osteoblasts and some decreases in bone production in patients with recurrent nephrolithiasis.