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Characteristic No Low Bone Density (n=57,338) Low Bone Density (n=3402) Age, yr 48 (5) 51 (4) Race, white 55,491 (97) 3331 (98) Body mass index, kg/m2 27.1 (6.3) 24.5 (5.1) Postmenopausal 18,604 (32) 2192 (64) Bisphosphonate use 95 (<1) 282 (8) History of hypertension 9788 (18) 531 (16) History of diabetes 1697 (3) 65 (2) Family history of kidney stones 8026 (14) 535 (16) Thiazide use 4038 (7) 237 (7) Fluid intake, L/d 1.9 (0.8) 1.9 (0.8) Dietary calcium intake, mg/d 949 (420) 958 (438) Dietary potassium intake, mg/d 3228 (1034) 3250 (1017) Median calcium supplement (25%–75%), mg/d 450 (0, 1162) 1000 (500, 1167) Total vitamin D intake, IU 487 (320) 679 (379) Data are presented as N (%) with dietary intake and urinary factors presented as mean (SD) unless otherwise indicated.
- Table 2.
Age- and multivariable-adjusted relative risks for incident kidney stones by low bone density (1995–2013)
No Low Bone Density Low Bone Density P Value Cases 2302 262 Person-yr 1,081,620 98,240 Age-adjusted RR 1.0 (ref) 1.24 (1.08, 1.42) 0.002 MV-adjusted RR 1.0 (ref) 1.39 (1.20, 1.62) <0.001 Data are presented as number of cases or person-years and RR (95% confidence interval). Multivariable model: Adjusted for age, body mass index, dietary factors (calcium, magnesium, potassium, sucrose, fructose, sodium, animal protein, vitamin D, vitamin C, phosphorus, alcohol, caffeine, total fluid), supplemental calcium intake, thiazide, family history of kidney stones, history of hypertension, history of diabetes mellitus, menopausal status, bisphosphonate use, and postmenopausal hormone use. RR, relative risk; ref, reference; MV, multivariable.
- Table 3.
Age- and multivariable-adjusted relative risks of incident kidney stones by bisphosphonate use among participants (n=17,075) with low bone density (2007–2013)
No Bisphosphonate Use Bisphosphonate Use P Value Cases 154 42 Person-yr 52,240 20,494 Age-adjusted RR 1.0 (ref) 0.69 (0.49, 0.97) 0.03 MV-adjusted RR 1.0 (ref) 0.68 (0.48, 0.98) 0.03 Data are presented as number of cases or person-years and RR (95% confidence interval). Multivariable model: Adjusted for age, body mass index, dietary factors (calcium, magnesium, potassium, sucrose, fructose, sodium, animal protein, vitamin D, vitamin C, phosphorus, alcohol, caffeine, total fluid), supplemental calcium, thiazide, family history of kidney stones, history of hypertension, history of diabetes mellitus, menopausal status, and postmenopausal hormone use. RR, relative risk; ref, reference; MV, multivariable.
Characteristics No Low Bone Density (n=1836) Low Bone Density (n=458) Age, yr 53.6 (3.2) 55.3 (2.8) Race, white 1792 (98) 449 (98) BMI, kg/m2 25.8 (4.9) 23.6 (3.9) Postmenopausal 1121 (61) 379 (82) History of hypertension 49 (3) 11 (2) History of diabetes 26 (1) 9 (2) History of kidney stones 46 (46 (2.5) 16 (3.5) Family history of kidney stones 296 (16) 88 (19) Thiazide use 37 (2) 12 (3) Dietary intake Fluid intake, L/d 1.7 (0.7) 1.6 (0.7) Vitamin D intake, IU 1006 (786) 1340 (794) Calcium intake, mg/d 959 (409) 954 (414) Median calcium supplement (25%–75%), mg/d 500 (0–1000) 800 (500–1024) Urinary factors Volume, L/d 2.1 (0.9) 2.1 (0.8) Calcium, mg/d 200 (92) 214 (98) Sodium, mEq/d 139 (54) 125 (52) Oxalate, mg/d 31 (11) 31 (12) Magnesium, mg/d 107 (37) 111 (43) Citrate, mg/d 804 (283) 789 (262) Potassium, mEq/d 65 (20) 65 (21) Sulfate, mEq/d 38 (11) 35 (11) Phosphorus, mg/d 846 (244) 766 (234) Ammonium, mmol/d 30 (10) 27 (9) Creatinine, mg/d 1254 (206) 1151 (190) Categoric variables are presented as N (%) unless otherwise indicated. Continuous variables are presented as mean (SD) unless otherwise indicated. BMI, body mass index.
- Table 5.
Adjusted difference in 24-hour urinary calcium excretion for participants with history of low bone density (n=458) compared with participants without low bone density (n=1836)
Model Difference in Urinary Calcium (mg/d) for Low Bone Density 95% CI P Value Age-adjusted 16 6 to 26 0.002 MV-adjusted 10 1 to 19 0.02 Multivariable model: Adjusted for age, body mass index, bisphosphonate use, thiazide use, supplemental calcium intake, dietary calcium intake, total vitamin D intake, menopausal status, and urinary factors (volume, sodium, magnesium, citrate, potassium, sulfate, phosphorus, creatinine). 95% CI, 95% confidence interval; MV, multivariable.
- Table 6.
Adjusted difference in 24-hour urinary calcium excretion for participants with history of low bone density who were on a bisphosphonate (n=68) compared with participants who were not on a bisphosphonate (n=390)
Model Difference in Urinary Calcium (mg/d) for Bisphosphonate Use 95% CI P Value Age-adjusted 3 −23 to 28 0.82 MV-adjusted −2 −25 to 20 0.83 Multivariable model: Adjusted for age, body mass index, thiazide use, supplemental calcium intake, dietary calcium intake, total vitamin D intake, menopausal status, and urinary factors (volume, sodium, magnesium, citrate, potassium, sulfate, phosphorus, creatinine). 95% CI, 95% confidence interval; MV, multivariable.
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