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Trastornos de los mecanismos renales de acidificación en pacientes osteoporóticos. / [Renal acidification mechanism disorders in patients with osteoporosis]
Sánchez, A; Libman, J.
Afiliación
  • Libman, J; Centro de Endocrinología, Rosario, Argentina..
Medicina (B.Aires) ; 55(3): 197-202, 1995.
Article en Es | BINACIS | ID: bin-37238
Biblioteca responsable: AR2.1
ABSTRACT
Eight patients (6 women and 2 men) with osteoporosis caused or aggravated by renal acidification defects are presented. Three of the female patients were premenopausal; the others were 9, 20 and 22 years postmenopausal, and two of them were on hormonal replacement therapy. Two patients had nephrolithiasis one male with recurrent calcium phosphate stones and a left sided staghorn calculus, and one female with nephrocalcinosis due to medullary sponge kidney and hypercalciuria (patients No. 1 and 2, respectively, Table 1). In the remaining subjects, clinical suspicion was based on a) Hip fracture in a 44-yr-old premenopausal female without any risk factor (No. 3, Table 2). b) Several vertebral compression fractures in a 45-yr-old male without hypogonadism or other predisposing factors (No. 7, Table 2). c) Lack of response to antiosteoporotic therapy in 3 women (patients No. 4, 6 and 8, Table 2). Serum bicarbonate levels and urine acidification capacity were studied in all patients. Three had low serum bicarbonate (two of whom showed high fractional excretion of bicarbonate), four had a distal defect, and one had a mixed form. Serum creatinine and potassium, and venous blood pH were normal in all cases, suggesting incomplete renal tubular acidosis. Bone mineral density in Z-score (means +/- s.e.m.) was - 1.75 +/- 0.08 in the lumbar spine (n = 8), and - 1.57 +/- 0.09 in the femoral neck (n = 4) [Tables 1 and 2; Figs 1 and 2]. Following one year treatment with oral sodium bicarbonate and potassium citrate, total skeletal calcium increased by 3-10
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Colección: 06-national / AR Base de datos: BINACIS Tipo de estudio: Risk_factors_studies Idioma: Es Revista: Medicina (B.Aires) Año: 1995 Tipo del documento: Article Pais de publicación: Argentina
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Colección: 06-national / AR Base de datos: BINACIS Tipo de estudio: Risk_factors_studies Idioma: Es Revista: Medicina (B.Aires) Año: 1995 Tipo del documento: Article Pais de publicación: Argentina