Do patients with nephrolithiasis get bone disease from renal calcium losses?
Multiple studies have documented reduced bone mineral density in calcium stone formers, particularly those with idiopathic hypercalciuria.
Patients with hypercalciuria are likely to go into negative calcium balance when placed on a low-calcium diet. Because many patients avoid dairy products after a stone episode, they may be contributing to their bone loss. Higher fracture rates have been noted in stone formers.
To treat bone loss, diet calcium should be 1000 to 1200 mg/day and diet sodium should be 2300 to 3000 mg/day. Thiazide diuretics can improve bone mineral level and reduce stone risk.