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.
