Effects of aminobisphosphonates and thiazides in patients with osteopenia/osteoporosis, hypercalciuria, and recurring renal calcium lithiasis

Urology. 2013 Apr;81(4):731-7. doi: 10.1016/j.urology.2012.12.013. Epub 2013 Jan 30.


Objective: To analyze the effects of aminobisphosphonates and thiazides on renal lithogenic activity and bone mineral density in patients with recurring renal calcium lithiasis.

Materials and methods: A prospective cohort study with 3 years of clinical follow-up data was performed. The study included 2 groups of patients with recurring calcium lithiasis, hypercalciuria, and bone mineral density loss. Group 1 included 35 patients who underwent treatment with 70 mg/wk alendronate. Group 2 included 35 patients who underwent treatment with 50 mg/d hydrochlothiazide and 70 mg/wk alendronate. Biochemical analysis was performed at baseline, 6 months, and 2 years, bone densitometry at baseline and 2 years, and clinical follow-up during the 3 years of treatment. The biochemical variables from the blood and urine samples, recurrent lithiasis, and bone mineral density were analyzed.

Results: Age, sex, baseline biochemical markers, and bone density showed no differences between the 2 treatment groups at the onset of treatment. After 2 years of treatment, group 1 showed a significant decrease in bone turnover markers and calciuria and significant improvement in bone mineral density. After 2 years of treatment, group 2 showed a decrease in calciuria and bone markers. At 2 years, the decrease in calciuria and the improvement in bone mineral density were greater in group 2 than in group 1, and the difference was statistically significant.

Conclusion: Aminobisphosphonates improve bone mineral density and slow lithogenic activity; however, administration of aminobisphosphonates in association with thiazides produced the same clinical effects and also reduced calciuria and improved bone mineral density.

MeSH terms

  • Alendronate / therapeutic use*
  • Bone Density
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Diseases, Metabolic / drug therapy*
  • Calcium / analysis
  • Female
  • Humans
  • Hydrochlorothiazide / therapeutic use
  • Hypercalciuria / drug therapy*
  • Kidney Calculi / chemistry
  • Male
  • Middle Aged
  • Nephrolithiasis / drug therapy*
  • Osteoporosis / drug therapy
  • Prospective Studies
  • Recurrence
  • Sodium Chloride Symporter Inhibitors / therapeutic use*


  • Bone Density Conservation Agents
  • Sodium Chloride Symporter Inhibitors
  • Hydrochlorothiazide
  • Calcium
  • Alendronate