Patients with recurrent calcium nephrolithiasis and fasting hypercalciuria have a higher incidence of osteopenia and osteoporosis. They present increased BTMs (mainly resorptive) and up to 30% have hypocitraturia and increased urinary calcium/citrate ratio (>0.25). Medical therapy is aimed at improving the dietary habits, prescribing combinations of potassium citrate, thiazides, and bisphosphonates, and correcting bone and urinary abnormalities.

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