Bone mineral density in children with myelomeningocele: Effect of hydrochlorothiazide

Albert Quan, Richard Adams, Elaine Ekmark, Michael Baum

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Children with myelomeningocele experience difficulty with ambulation, which leads to immobilization and secondary loss of bone mineral density (BMD). In addition, non-ambulatory myelomeningocele patients have higher urinary calcium losses than their ambulatory counterparts. Hydrochlorothiazide (HCTZ) is known to reduce urinary calcium loss and increase BMD in non-myelomeningocele patients with hypercalciuria. This study examines the effect of HCTZ on urinary calcium and BMD in non-ambulatory children with myelomeningocele. Thirteen of 20 non-ambulatory patients with myelomeningocele completed the year-long randomized double-blinded study (placebo = 7 and HCTZ = 6). Evaluation included electrolytes, PTH, osteocalcin, 1, 25-OH vitamin D, urinary pyridinolines/deoxypyridinolines (Upyr/dpyr), urinary calcium/creatinine (UCa/Cr), and forearm BMD (dual X-ray absorptiometry). Follow-up electrolytes were obtained at 1-2, 6, and 12 months and UCa/Cr and BMD was obtained again at 12 months. There were no initial differences between the placebo and HCTZ groups. UCa/Cr decreased in the HCTZ group after treatment (0.20±0.09 vs. 0.04±0.02, p<0.05). However, forearm BMD (z-scores) after 1 year remained unchanged in both the HCTZ (-5.95±0.98 to -5.86±0.92) and placebo (-7.19±0.69 to -6.67±0.63) groups. While use of HCTZ for 1 year did not affect BMD, it reduced urinary calcium excretion in non-ambulatory children with myelomeningocele.

Original languageEnglish (US)
Pages (from-to)929-933
Number of pages5
JournalPediatric Nephrology
Volume18
Issue number9
DOIs
StatePublished - Sep 1 2003

Keywords

  • Bone densitometry
  • Bone mineral density
  • Hydrochlorothiazide
  • Myelomeningocele
  • Urinary calcium excretion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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