Nephrolithiasis-associated bone disease: Pathogenesis and treatment options

Khashayar Sakhaee, Naim M. Maalouf, Rajiv Kumar, Andreas Pasch, Orson W. Moe

Research output: Contribution to journalReview articlepeer-review

98 Scopus citations


Nephrolithiasis remains a formidable health problem in the United States and worldwide. A very important but underaddressed area in nephrolithiasis is the accompanying bone disease. Epidemiologic studies have shown that osteoporotic fractures occur more frequently in patients with nephrolithiasis than in the general population. Decreased bone mineral density and defects in bone remodeling are commonly encountered in patients with calcium nephrolithiasis. The pathophysiologic connection of bone defects to kidney stones is unknown. Hypercalciuria and hypocitraturia are two important risk factors for stone disease, and treatments with thiazide diuretics and alkali, respectively, have been shown to be useful in preventing stone recurrence in small prospective trials. However, no studies have examined the efficacy of these agents or other therapies in preventing continued bone loss in calcium stone formers. This manuscript reviews the epidemiology, pathophysiology, and potential treatments of bone disease in patients with nephrolithiasis.

Original languageEnglish (US)
Pages (from-to)393-403
Number of pages11
JournalKidney international
Issue number4
StatePublished - Feb 2011


  • bone disease
  • citrate
  • kidney stone
  • nephrolithiasis
  • thiazide

ASJC Scopus subject areas

  • Nephrology


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