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 absorptiometry and dual energy x-ray absorptiometry, and the various biochemical parameters related to bone metabolism in patients with Kock reservoirs or Bricker conduits for urinary diversion. Materials and Methods: We 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 diversion. Bone mineral density was measured in the radius with single photon absorptiometry, and in the femur, lumbar spine and whole body with dual x-ray absorptiometry. Serum concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized calcium were determined. Arterial blood gasses were analyzed. Results: The mean values for bone mineral 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. Most patients had normal blood gas values. Mean values for osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized calcium also were within normal limits, although a few patients had elevated osteocalcin values indicating increased bone turnover. Conclusions: Urinary diversion with a Kock reservoir or Bricker conduit did not cause bone demineralization or significant changes in different markers of bone metabolism in patients examined 2 to 17 years after urinary diversion.