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Risk of renal stone formation in patients treated with luteinising hormone-releasing hormone analogues for prostate cancer: importance of bone metabolism and urine calcium

  • Urology - Original Paper
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Abstract

Purpose

To determine whether androgen blockade produces metabolic changes in urine and increases the risk of calculi after 1 year of treatment.

Materials and methods

The study included 38 patients, from the period April 2015 to June 2016, diagnosed with locally advanced prostate cancer or lymph node metastasis, and with an indication of androgen blockade. Androgen blockade was started with luteinising hormone-releasing hormone (LHRH) analogues, and a blood specimen, a fasting urine and 24-h urine were collected at the time of inclusion, and then at 1 year of follow-up. A study was performed at baseline and at 1 year with imaging tests. An analysis of the variables was performed with a p ≤ 0.05 considered as statistically significant.

Results

The mean age of the patients included in the study was 72.26 ± 6.75 years. As regards the biochemistry parameters, an increase in osteocalcin (from 16.28 ± 9.48 to 25.56 ± 12.09 ng/ml; p = 0.001) and an increase in β-crosslaps (from 0.419 ± 0.177 to 0.743 ± 0.268 ng/ml; p = 0.0001) were observed. In the urinary parameters, a significant increase was observed in the fasting calcium/creatinine ratio (from 0.08 ± 0.06 to 0.13 ± 0.06; p = 0.002) and in the 24-h calcium renal excretion (from 117.69 ± 66.92 to 169.42 ± 107.18 mg; p = 0.0001). Calculi formation was observed in 12 of the 38 patients included (31.6%), with a mean size of 3.33 ± 1.31 mm.

Conclusion

Treatment with LHRH analogues, as well as increasing the appearance of metabolic syndrome and speeding up the loss bone mineral density, causes an increase in fasting urine calcium.

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Acknowledgements

This study is the doctoral thesis of Enrique Diaz Convalia, Granada University. Program of Medicina Clinica and Salud Publica.

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Authors and Affiliations

  1. Urology Department, Hospital Universitario San Cecilio, Plaza Ciudad de los Carmenes, 4, 6D, 18013, Granada, Spain

    Enrique Diaz-Convalia, Miguel Angel Arrabal-Polo, Maria del Carmen Cano-Garcia, Alejandro Dominguez-Amillo, Nelson Canales-Casco & Miguel Arrabal-Martin

  2. Instituto IBS Granada, Granada, Spain

    Enrique Diaz-Convalia, Miguel Angel Arrabal-Polo, Maria del Carmen Cano-Garcia, Alejandro Dominguez-Amillo, Nelson Canales-Casco & Miguel Arrabal-Martin

Authors
  1. Enrique Diaz-Convalia
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  2. Miguel Angel Arrabal-Polo
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  3. Maria del Carmen Cano-Garcia
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  4. Alejandro Dominguez-Amillo
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  5. Nelson Canales-Casco
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  6. Miguel Arrabal-Martin
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Contributions

EDC contributed to design, data collection, analysis, and writing, MAAP involved in data collection, design, and writing, MCCG contributed to data collection and design, ADA and NCC involved in data collection, and MAM involved in supervision and design.

Corresponding author

Correspondence to Miguel Angel Arrabal-Polo.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical standard

The Good Clinical Practice guidelines have been put into practice and followed, as well as those of the Helsinki Declaration in its latest version (Fortaleza, Brazil). The patients have received a detailed information sheet about the study and have voluntarily and consciously signed the consent to participate in the study. This study forms part of a research study for a doctoral thesis enrolled in the University of Granada (Spain), within the PhD program of Clinical Medicine and Public Health.

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Diaz-Convalia, E., Arrabal-Polo, M.A., Cano-Garcia, M.C. et al. Risk of renal stone formation in patients treated with luteinising hormone-releasing hormone analogues for prostate cancer: importance of bone metabolism and urine calcium. Int Urol Nephrol 50, 419–425 (2018). https://doi.org/10.1007/s11255-018-1793-1

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  • DOI: https://doi.org/10.1007/s11255-018-1793-1

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