perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2016-61-5-160-165perinatology-400Research ArticleXIII РОССИЙСКАЯ КОНФЕРЕНЦИЯ «ПЕДИАТРИЯ И ДЕТСКАЯ ХИРУРГИЯ В ПРИВОЛЖСКОМ ФЕДЕРАЛЬНОМ ОКРУГЕ»13TH RUSSIAN CONFERENCE ON PEDIATRICS AND PEDIATRIC SURGERY IN THE VOLGA FEDERAL DISTRICTСнижение минеральной плотности кости у детей с гиперкальциурией, нефролитиазом и нефрокальцинозомReduced bone mineral density in children with hypercalciuria, nephrolithiasis and nephrocalcinosisМальцевС. В.MaltsevC. V.

кафедра педиатрии с курсом поликлинической педиатрии 

д.м.н., проф. 

420012 Казань, ул. Бутлерова, д. 36

МихайловаТ. В.MikhailovaT. V.

кафедра педиатрии с курсом поликлинической педиатрии

к.м.н., доцент кафедры 

420012 Казань, ул. Бутлерова, д. 36

ВинокуроваС. С.VinokurovaS. S.

кафедра педиатрии с курсом поликлинической педиатрии

лаборант кафедры

420012 Казань, ул. Бутлерова, д. 36

ГБОУ ДПО «Казанская государственная медицинская академия» Минздрава России, КазаньРоссияKazan state medical Academy, KazanRussian Federation201620112016615160165Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20162016Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/400

Представлены результаты обследования 105 детей в возрасте 1–16 лет, у 22 из них диагностирован нефрокальциноз, у 11 — нефролитиаз на фоне гиперкальциурии, у 23 наблюдалась гиперкальциурия без образования конкрементов и кальцинатов в органах мочевой системы; 49 детей страдали хроническим обструктивно-дисметаболическим пиелонефритом. У детей с гиперкальциурией, нефролитиазом и нефрокальцинозом снижение минеральной плотности кости наблюдалось у 45% детей, при хроническом обструктивно-дисметаболическом пиелонефрите остеопения была выявлена у 51% больных. Снижение минеральной плотности кости у детей с гиперкальциурией повышало риск развития переломов. Переломы костей в анамнезе имели 1/3 детей с остеопенией, двух- и трехкратные переломы наблюдались в 3 раза чаще, чем у детей группы сравнения. Увеличение в сыворотке крови содержания костного изофермента щелочной фосфатазы и кислой фосфатазы отражало равную степень выраженности как процессов костной резорбции, так и костеобразования у детей с гиперкальциури- ей. У больных хроническим пиелонефритом с выраженной остеопенией наблюдалось усиление процессов костной резорбции по отношению к костеобразованию. 

The article presents the results of a examination of 105 children aged 1 to 16 years, 22 of them are diagnosed with nephrocalcinosis, 11 stone in the urinary system amid hypercalciuria, 23 hypercalciuria was observed without the formation of concretions in the urinary system, 49 children with chronic pyelonephritis. In children with hypercalciuria, nephrolithiasis and nephrocalcinosis decreased bone mineral density was observed in 45% of cases, in children with chronic pyelonephritis osteopenia was found in half of the patients (51%). Reduced bone mineral density in children with hypercalciuria increased risk of fractures. In patients with osteopenia two-and three-multiples fractures were observed in 3 times more than the comparison group. Increase both of alkaline phosphatase and acidic phosphatase showed activation of bone metabolism, and proportionality of their activation determined state of bone mineral density. Patients with chronic pyelonephritis with severe osteopenia observed prepotency of processes of bone resorption relative to bone formation. 

детигиперкальциуриянефролитиазнефрокальцинозпиелонефритснижение минеральной плотности костиchildrenhypercalciurianephrolithiasisnephrocalcinosislow bone mineral densityReferencesArrabal-Polo M.A., Arrabal-Martin M., de Haro-Munoz T. et al. Mineral density and bone remodelling markers in patients with calcium lithiasis. BJU Int 2011; 108: 12: 1903– 1908.Arrabal-Polo M.A., Arrabal-Martin M., de Haro-Munoz T. et al. Mineral density and bone remodelling markers in patients with calcium lithiasis. BJU Int 2011; 108: 12: 1903– 1908.Arrabal-Polo M.A., Arrabal-Martin M., Arias-Santiago S. et al. Metabolic-mineral study in patients with renal calcium lithiasis, severe lithogenic activity and loss of bone mineral density. Singapore Med J 2012; 53: 12: 808–813.Arrabal-Polo M.A., Arrabal-Martin M., Arias-Santiago S. et al. Metabolic-mineral study in patients with renal calcium lithiasis, severe lithogenic activity and loss of bone mineral density. Singapore Med J 2012; 53: 12: 808–813.Aruga S., Honma Y. Renal calcium excretion and urolithiasis. Clin Calcium 2011; 21: 10: 1465–1472.Aruga S., Honma Y. Renal calcium excretion and urolithiasis. Clin Calcium 2011; 21: 10: 1465–1472.Bijelic R., Milicevic S., Balaban J. Incidence of osteoporosis in patients with urolithiasis. Med Arch 2014; 68: 5: 335–338.Bijelic R., Milicevic S., Balaban J. Incidence of osteoporosis in patients with urolithiasis. Med Arch 2014; 68: 5: 335–338.Bone mineral density status in urolithiasis patients with vita￾min D inadequacy followed at a tertiary stone centre. Canad Urol Ass J 2014; 8: 10: 323–328.Bone mineral density status in urolithiasis patients with vita￾min D inadequacy followed at a tertiary stone centre. Canad Urol Ass J 2014; 8: 10: 323–328.Celik A., Davutoglu V., Sakip Erturhan K. et al. Relationship between renal stone formation, mitral annular calcification and bone resorption markers. Ann Saudi Med.2010; 30: 8: 301–305.Celik A., Davutoglu V., Sakip Erturhan K. et al. Relationship between renal stone formation, mitral annular calcification and bone resorption markers. Ann Saudi Med.2010; 30: 8: 301–305.Длин В.В., Османов И.М., Новиков П.В. и др. Дисмета- болическая нефропатия, мочекаменная болезнь и не- фрокальциноз у детей. М: Оверлей, 2005; 232. (Dlin V.V., Osmanov I.M., Novikov P.V. et al. Dysmetabolic nephropathy, urolithiasis and nephrocalcinosis in children. M: Overlej, 2005; 232. (in Russ))Длин В.В., Османов И.М., Новиков П.В. и др. Дисмета- болическая нефропатия, мочекаменная болезнь и не- фрокальциноз у детей. М: Оверлей, 2005; 232. (Dlin V.V., Osmanov I.M., Novikov P.V. et al. Dysmetabolic nephropathy, urolithiasis and nephrocalcinosis in children. M: Overlej, 2005; 232. (in Russ))Ryan L.E., Ing S.W. Idiopathic hypercalciuria and bone health. Curr Osteoporos Rep 2012; 10: 4: 286–295.Ryan L.E., Ing S.W. Idiopathic hypercalciuria and bone health. Curr Osteoporos Rep 2012; 10: 4: 286–295.Sakhaee D.K., Maalouf N.M., Kumar R. et al. Nephrolithiasisassociated bone disease: pathogenesis and treatment options. Kidney Int 2011; 79: 2: 393–403.Sakhaee D.K., Maalouf N.M., Kumar R. et al. Nephrolithiasisassociated bone disease: pathogenesis and treatment options. Kidney Int 2011; 79: 2: 393–403.Schwaderer A.L., Cronin R., Mahan J.D. et al. Low bone density in children with hypercalciuria and/or nephrolithiasis. Pediatr Nephrol 2008; 23: 12: 2209–2214.Schwaderer A.L., Cronin R., Mahan J.D. et al. Low bone density in children with hypercalciuria and/or nephrolithiasis. Pediatr Nephrol 2008; 23: 12: 2209–2214.Яровой С.К., Максудов P.P. Нефролитиаз и метаболические остеопатии на фоне соматических заболеваний. Экспер и клин урол 2015; 1: 108–114. (Jarovoj S.K., Maksudov P.P. Nephrolithiasis and metabolic osteopathy at various systemic diseases. Jeksper i klin urol 2015; 1: 108– 114. (in Russ))Яровой С.К., Максудов P.P. Нефролитиаз и метаболические остеопатии на фоне соматических заболеваний. Экспер и клин урол 2015; 1: 108–114. (Jarovoj S.K., Maksudov P.P. Nephrolithiasis and metabolic osteopathy at various systemic diseases. Jeksper i klin urol 2015; 1: 108– 114. (in Russ))Moreira Guimarães Penido M.G., de Sousa Tavares M., Campos Linhares M. et al. Longitudinal study of bone mineral density in children with idiopathic hypercalciuria. Pediatr Nephrol 2012; 27: 1: 123–130.Moreira Guimarães Penido M.G., de Sousa Tavares M., Campos Linhares M. et al. Longitudinal study of bone mineral density in children with idiopathic hypercalciuria. Pediatr Nephrol 2012; 27: 1: 123–130.Zerwekh J.E. Bone disease and hypercalciuria in children. Pediatr Nephrol 2010; 25: 3: 395–401.Zerwekh J.E. Bone disease and hypercalciuria in children. Pediatr Nephrol 2010; 25: 3: 395–401.Knoll T. Epidemiology, Pathogenesis, and Pathophysiology of Urolithiasis. Eur Urol 2010; 9: 802–806.Knoll T. Epidemiology, Pathogenesis, and Pathophysiology of Urolithiasis. Eur Urol 2010; 9: 802–806.Romero V., Akpinar H., Assimos D.G. Kidney Stones: A Global Picture of Prevalence, Incidence, and Associated Risk Factors. RevUrol 2010; 12: 2–3: 86–96.Romero V., Akpinar H., Assimos D.G. Kidney Stones: A Global Picture of Prevalence, Incidence, and Associated Risk Factors. RevUrol 2010; 12: 2–3: 86–96.Gunes S., Bilen C.Y., Kara N. et al. Vitamin D receptor gene polymorphisms in patients with urolithiasis. Urol Res 2006; 34: 47–52.Gunes S., Bilen C.Y., Kara N. et al. Vitamin D receptor gene polymorphisms in patients with urolithiasis. Urol Res 2006; 34: 47–52.Dimke H., Desai P., Borovac J. et al. Activation of the Ca (2+) — sensing receptor increases renal claudin-14 expression and urinary Ca (2+) excretion. Am J Physiol Renal Physiol 2013; 304: 6: F761–769.Dimke H., Desai P., Borovac J. et al. Activation of the Ca (2+) — sensing receptor increases renal claudin-14 expression and urinary Ca (2+) excretion. Am J Physiol Renal Physiol 2013; 304: 6: F761–769.Thorleifsson G., Holm H., Edvardsson V. et al. Sequence variants in the CLDN14 gene associate with kidney stones and bone mineral density. Nature Genet 2009; 41: 926–930.Thorleifsson G., Holm H., Edvardsson V. et al. Sequence variants in the CLDN14 gene associate with kidney stones and bone mineral density. Nature Genet 2009; 41: 926–930.Muller D., Kausalya P.J., Bockenhauer D. et al. Unusual clinical presentation and possible rescue of a novel claudin-16 mutation. J Clin Endocr Metab 2006; 91: 3076–3079.Muller D., Kausalya P.J., Bockenhauer D. et al. Unusual clinical presentation and possible rescue of a novel claudin-16 mutation. J Clin Endocr Metab 2006; 91: 3076–3079.Arrabal-Polo M.A., Arias-Santiago S., de Haro-Munoz T. Effects of aminobisphosphonates and thiazides in patients with osteopenia/osteoporosis, hypercalciuria, and recurring renal calcium lithiasis. Urology 2013; 81: 731–737.Arrabal-Polo M.A., Arias-Santiago S., de Haro-Munoz T. Effects of aminobisphosphonates and thiazides in patients with osteopenia/osteoporosis, hypercalciuria, and recurring renal calcium lithiasis. Urology 2013; 81: 731–737.Bianchi G., Giusti A., Pioli G. Bisphosphonates in the management of idiopathic hypercalciuria associated with osteoporosis: a new trick from an old drug. Ther Adv Musculoskel Dis 2010; 2: 1: 29–35.Bianchi G., Giusti A., Pioli G. Bisphosphonates in the management of idiopathic hypercalciuria associated with osteoporosis: a new trick from an old drug. Ther Adv Musculoskel Dis 2010; 2: 1: 29–35.Смолянский Б.Л. Руководство по лечебному питанию. Л: Медицина 1981; 280. (Smoljanskij B.L. For clinical nutrition guide. L: Meditsina 1981; 280. (in Russ))Смолянский Б.Л. Руководство по лечебному питанию. Л: Медицина 1981; 280. (Smoljanskij B.L. For clinical nutrition guide. L: Meditsina 1981; 280. (in Russ))Покровский А.А., Самсонов М.А. Справочник по дието- логии I. М: Медицина 1981; 701. (Pokrovskij A.A., Samsonov M.A. Handbook of Nutrition I. Moscow: Meditsina 1981; 280. (in Russ))Покровский А.А., Самсонов М.А. Справочник по дието- логии I. М: Медицина 1981; 701. (Pokrovskij A.A., Samsonov M.A. Handbook of Nutrition I. Moscow: Meditsina 1981; 280. (in Russ))

The authors declare that there are no conflicts of interest present.