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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?

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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?

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3 Answers
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Nephrology · Mayo Clinic
Answered on

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, so...

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Mednet MemberInvited Expert
Nephrology · Ohio State University Medical Center
Answered on

I agree with Dr. @Dr. First Last; 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 r...

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Mednet Member
Endocrinology · University of Missouri School of Medicine
Answered on

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 ...

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