BONE-MINERAL AND RELATED BIOCHEMICAL VARIABLES IN PATIENTS WITH KOCK ILEAL RESERVOIR OR BRICKER CONDUIT FOR URINARY-DIVERSION

Purpose: Bone mineral content was studied with single photon absorptio metry and dual energy x-ray absorptiometry, and the various biochemica l parameters related to bone metabolism in patients with Kock reservoi rs or Bricker conduits for urinary diversion. Materials and Methods: W e examined 34 patients with Kock ileal reservoirs to the skin (29) or urethra (5) and 14 with Bricker conduits 2 to 17 years after urinary d iversion. Bone mineral density was measured in the radius with single photon absorptiometry, and in the femur, lumbar spine and whole body w ith dual x-ray absorptiometry. Serum concentrations of 25-hydroxyvitam in D, 1,25-dihydroxyvitamin D, osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized calcium were determined. Art erial blood gasses were analyzed. Results: The mean values for bone mi neral density did not differ from age-matched controls in either group and no signs of decrease were observed with followup. Vitamin D serum concentration values remained within normal limits in all patients. M ost patients had normal blood gas values. Mean values for osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized c alcium also were within normal limits, although a few patients had ele vated osteocalcin values indicating increased bone turnover. Conclusio ns: Urinary diversion with a Kock reservoir or Bricker conduit did not cause bone demineralization or significant changes in different marke rs of bone metabolism in patients examined 2 to 17 years after urinary diversion.