The course of hypercalciuria and related markers of bone metabolism parameters associated with corticosteroid treatment

• Published in: Renal failure Vol. 34; no. 3; p. 338
• Main Authors: Duzen, Omer, Erkoc, Reha, Begenik, Huseyin, Soyoral, Yasemin Usul, Aldemir, Mehmet Naci
• Format: Journal Article
• Language: English
• Published: England 01-04-2012
• Subjects: Adolescent; Adult; Aged; Amino Acids - urine; Biomarkers - metabolism; Bone and Bones - drug effects; Bone and Bones - metabolism; Calcium - urine; Creatinine - blood; Creatinine - urine; Dose-Response Relationship, Drug; Female; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Humans; Hypercalciuria - chemically induced; Hypercalciuria - metabolism; Male; Methylprednisolone - administration & dosage; Methylprednisolone - adverse effects; Middle Aged; Osteocalcin - blood; Osteoporosis - chemically induced; Osteoporosis - metabolism; Parathyroid Hormone - blood; Risk Factors; Sodium - urine; Young Adult
• ISSN: 1525-6049
• DOI: 10.3109/0886022X.2011.648596

Prolonged corticosteroid (CS) use induces osteoporosis; the pathogenesis of this condition is multifactorial and includes CS-induced hypercalciuria. We investigated the course of hypercalciuria and related markers of bone metabolism parameters during and after the CS treatment.
We recruited 42 patients who were taking at least 10 mg/day of methylprednisolone or an equivalent dose of CSs for at least 30 days. The 24-h urinary calcium and sodium, a spot urinary calcium/creatinine ratio, and urinary deoxypyridinoline were measured prior to the treatment, at day 7, at days 30-60, and after the cessation of the treatment. Additionally, the serum levels of phosphorus, calcium, alkaline phosphatase (ALP), albumin, creatinine, osteocalcin, and parathyroid hormone (PTH) were analyzed.
The 24-h urinary calcium excretion was significantly increased at day 7 (182.2 ± 158.6 mg/day; p < 0.001) and at days 30-60 (196.9 ± 167.8 mg/day; p < 0.001) compared with baseline (98.7 ± 88.1 mg/day) and returned to basal level after the cessation of the CSs (118.9 ± 90.2 mg/day; p = 0.725). The urinary deoxypyridinoline level was significantly higher at days 30-60 compared with basal level. The serum osteocalcin level was decreased at days 30-60 when compared with day 7. No significant changes were detected in the PTH, phosphorus, creatinine, and ALP levels.
CS treatment induces hypercalciuria just after starting the treatment until the end of it. CS-induced hypercalciuria promptly improved after cessation of the treatment. By days 30-60, the excretion of urinary deoxypyridinoline was accompanied by hypercalciuria. The serum osteocalcin level was decreased at days 30-60 when compared with day 7.