How long do you wait before reassessing a 24 hour urine calcium level in patients with recurrent nephrolithiasis, hypercalciuria, and osteoporosis who are initiated on bisphosphonate therapy?
Answer from: at Academic Institution
Thank you for your excellent question. This is a relatively common concern, and yet I am aware of very little hard data. Opinions will differ; here is mine:
In this scenario, it is my practice to have the patient visit with our Stone Clinic dietitian regarding dietary recommendations for calcium, s...
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Answer from: at Community Practice
I agree with Dr. @Erickson; there is very little literature on this topic.I think, to answer this question, we need to understand if bisphosphate therapy alters UrCa levels, and if so, when is their peak and steady-state effect given their long half-lives? Dr. Curhan's group did look at this retrosp...
Answer from: at Academic Institution
In patients with hypercalciuria and osteoporosis, along with bisphosphonates, I also include hydrochlorothiazide daily and encourage good fluid intake with a moderate sodium diet.
In 4 to 8 weeks, I recheck the 24-hour urine calcium and target a 24-hour urine calcium of less than 200 mg. I instruct...