Metabolic Workup in Patients Suffering From Kidney Stone Disease and Osteopenia

Study Overview
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Brief Summary
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Patients suffering from acute renal colic are evaluated by non contrast computerized tomography with excellent identification rates of urinary stones. The scan also covers the bones of the ribs, spine and pelvis, allowing measurements of the bone density and identifying early osteopenic changes. Bone demineralization is associated with metabolic changes such as hypercalcemia or hypercalcuria. In this study the investigators will look for correlation between kidney stones, osteopenic bone changes and metabolic abnormalities.

Detailed Description
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Kidney stones are a common medical condition found in more then 5% of the adult population. The stones might cause severe pain (due to acute obstruction of a renal unit) , deterioration of renal function and urinary tract infection. One of the causes of kidney stones is metabolic changes such as hypercalcemia or hyperoxaluria. Basic evaluation of kidney stones patients include measurements of calcium, phosphor and uric acid in the serum and is often negative. Thorough metabolic workup including 24 hours urine collection is not cost effective and is reserved for patients with frequent recurrence of stone disease. Metabolic abnormalities are often associated with bone demineralization, of which the patients are typically unaware. such changes can be detected by the CT scan. On the same scan, performed for identifying the stone, the radiologist can measure bone density, using the Hounsfield units, in the L2 vertebral body of and the acetabular area of the pelvis. In the study, in all patients undergoing CT scan due to renal colic, the bone density will be measured. Patients with abnormal bone density will undergo a complete metabolic workup including 24 hours collection of urine and measurements of urinary clearance of calcium, phosphorous, uric acid, oxalate and citrate . The investigators will look for correlation between osteopenic changes and metabolic abnormalities.

Official Title
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Metabolic Workup in Patients Suffering From Kidney Stone Disease and Show Osteopenic Bone Changes on Non-contrast CT Scan

Conditions
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Urolithiasis, Renal Colic, Osteopenia

Intervention / Treatment
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* Diagnostic Test: CT scan
* Diagnostic Test: 24 hour urine collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or old informed consent kidney stones CT scan positive for stones AND bone changes Exclusion Criteria: under 18 unable to sign no stones detected on scan (even if a stone was expelled recently) no bone changes pregnancy a patient already known to suffer from metabolic bone disease a patient with documented osteoporosis patients following spinal or pelvic trauma / surgery

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Interventional Model Description: cohort study of all patients presenting with renal colic
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: osteopenic patients<br>patients with a kidney stone and osteopenic changes. | Diagnostic Test: CT scan<br>* non contrast spiral CT of the urinary tract including the bony structures of the spine and pelvis<br>Diagnostic Test: 24 hour urine collection<br>* 24 hours collection of urine and measurement of the concentration of calcium, phosphorous, uric acid, oxalate and citrate<br>* Other names: uninalysis;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| correlation between abnormal metabolic changes and abnormal bone density on Ct scan | The rate of patients presenting with kidney stones and abnormal bone density and have abnormal urinary clearance of electrolytes. | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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osteopenia, urolithiasis, metabolic abnormalities, hypercalcemia, hypercalcuria, bone density